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114 results on '"Rainer Porschen"'

1. Dünndarm

Author

Wienke Ellerbeck, Christiane Fibbe, Korinna Fritz, Jutta Keller, Peter Layer, Viola Sophie Meier, Ulrike Melle, Stefan Michaelis, Sara Nader, Rainer Porschen, Ulrich Rosien, and Stephanie Thiel

Published
2023

2. Kolon

Author

Christiane Fibbe, Marie de Greck, Peter Layer, Niels Liedtke, Rainer Porschen, Ulrich Rosien, Henrike von Schassen, Sebastian Schulz, Julian Siegel, Alexander Stein, Friederike Todt, and Susanna Wolf

Published
2023

3. Adressen

Author

Ulrich Rosien, Thomas Berg, Peter Layer, Niklas Aehling, Margret Alm, Viola Andresen, Angelika Behrens, Franziska Bertram, Albrecht Böhlig, Johanna Carstensen, Marie de Greck, Christian Ell, Wienke Ellerbeck, Giulia Enders, Christiane Fibbe, Wolfgang Fischbach, Korinna Fritz, Antonia Gaus, Laura Gottschalk, Kai Daniel Grandt, Toni Herta, Dr. med. Dorothea Jasper, Jutta Keller, Nina Kschowak, Konstantin Lang, Alina Lange, Niels Liedtke, Janek Luttermann, Lida Mancke, Viola Sophie Meier, Ulrike Melle, Daniela Menge, Stefan Michaelis, Stefan Miehlke, Sara Nader, Tim-Alexander Niedergassel, Carsten Pachmann, Rainer Porschen, Solveig Rose, Martin Rössle, Melina Schellhorn, Oliver Schnell, Sebastian Schulz, Julian Siegel, Andreas Stallmach, Alexander Stein, Johannes Szuba, Sarah Lena Teising, Stephanie Thiel, Dr. med. Julia Thomas-Morr, Henriette Tillmann, Dr. med. Friederike Todt, Henrike von Schassen, Michael Wölfel, Susanna Wolf, Valentin Wolgast, Clara Wübbolding, and Kathrin Zimmermann

Published
2023

4. Leber

Author

Ulrich Rosien, Thomas Berg, Peter Layer, Margret Alm, Viola Andresen, Wolfgang Fischbach, Jutta Keller, Niels Liedtke, Stephan Miehlke, Rainer Porschen, Martin Rössle, Julian Siegel, Niklas Aehling, Daniel C. Baumgart, Angelika Behrens, Franziska Bertram, Albrecht Böhlig, Johanna Carstensen, Marie de Greck, Christian Ell, Wienke Ellerbeck, Giulia Enders, Christiane Fibbe, Korinna Fritz, Antonia Gaus, Laura Gottschalk, Kai Daniel Grandt, Toni Herta, Dorothea Jasper, Nina Kschowak, Konstantin Lang, Alina Lange, Janek Luttermann, Lida Mancke, Viola Sophie Meier, Ulrike Melle, Daniela Menge, Stefan Michaelis, Sara Nader, Tim-Alexander Niedergassel, Carsten Pachmann, Solveig Rose, Melina Schellhorn, Oliver Schnell, Sebastian Schulz, Alexander Stein, Johannes Szuba, Sarah Teising, Stephanie Thiel, Julia Thomas-Morr, Henriette Tillmann, Friederike Todt, Henrike von Schassen, Susanna Wolf, Michael Wölfel, Valentin Wolgast, Clara Wübbolding, and Kathrin Zimmermann

Published
2023

5. Microsatellite instability (MSI-H) is associated with a high immunoscore but not with PD-L1 expression or increased survival in patients (pts.) with metastatic colorectal cancer (mCRC) treated with oxaliplatin (ox) and fluoropyrimidine (FP) with and without bevacizumab (bev): a pooled analysis of the AIO KRK 0207 and RO91 trials

Author

Stefanie Noepel-Duennebacke, Aandrea Tannapfel, Jan Stoehlmacher, Hendrik Juette, U. Graeven, Anke Reinacher-Schick, Susanna Hegewisch-Becker, Karsten Schulmann, Rainer Porschen, Dirk Arnold, and Arne P. Raulf

Subjects
Male, PD-L1, Oncology, Neuroblastoma RAS viral oncogene homolog, Cancer Research, medicine.medical_specialty, Bevacizumab, Colorectal cancer, Immunoscore, Original Article – Clinical Oncology, Population, Subgroup analysis, medicine.disease_cause, B7-H1 Antigen, Internal medicine, Antineoplastic Combined Chemotherapy Protocols, Biomarkers, Tumor, medicine, Humans, Neoplasm Invasiveness, Overall survival, education, Randomized Controlled Trials as Topic, Retrospective Studies, education.field_of_study, Metastatic colorectal cancer, business.industry, Microsatellite instability, General Medicine, Middle Aged, Prognosis, medicine.disease, digestive system diseases, Oxaliplatin, Survival Rate, Clinical Trials, Phase III as Topic, Female, Fluorouracil, KRAS, Colorectal Neoplasms, business, Follow-Up Studies, medicine.drug
Abstract

Introduction In a retrospective analysis of two randomized phase III trials in mCRC patients treated first line with oxaliplatin, fluoropyrimidine with and without Bevacizumab (the AIO KRK 0207 and R091 trials) we evaluated the association of high microsatellite instability (MSI-H), immunoscore (IS) and PD-L1 expression in relation to overall survival (OS). Methods In total, 550 samples were analysed. Immunohistochemical analysis of the MMR proteins and additionally fragment length analysis was performed, molecular examinations via allele-discriminating PCR in combination with DNA sequencing. Furthermore PD-L1 and IS were assessed. Results MSI-H tumors were more frequent in right sided tumors (13.66% vs. 4.14%) and were correlated with mutant BRAF (p = 0.0032), but not with KRAS nor NRAS mutations (MT). 3.1% samples were found to be PD-L1 positive, there was no correlation of PDL1 expression with MSI-H status, but in a subgroup analysis of MSI-H tumors the percentage of PD-L1 positive tumors was higher than in MSS tumors (9.75% vs. 2.55%). 8.5% of samples showed a positive IS, MSI-H was associated with a high IS. The mean IS of the pooled population was 0.57 (SD 0.97), while the IS of MSI-H tumors was significantly higher (mean of 2.4; SD 1.4; p = Discussion Regarding OS in correlation with MSI-H, PD-L1 and IS status we did not find a significant difference. However, PD-L1 positive mCRC tended to exhibit a longer OS compared to PD-L1 negative cancers (28.9 vs. 22.1 months).

Published
2021

7. Autoreninnen und Autoren

Author

Marit Ahrens, Salah-Eddin Al-Batran, Robert Armbrust, Séverine Banek, Sven Becker, Lothar Bergmann, Jörg Bojunga, Tim Henrik Brümmendorf, Uta Brunnberg, Gesine Bug, Michael Burger, Jörg Chromik, Felix K.-H. Chun, Carolin Czauderna, Franz Ludwig Dumoulin, Martin Dreyling, Ahmed El-Balat, Jörg Ellinger, Susanne Elsner, Julius C. Enßle, Christian Fottner, Peter R. Galle, Nicola Gökbuget, Thorsten Oliver Götze, Teresa Halbsguth, Benedikt Höh, Peter Hohenberger, Joachim Hübner, Jutta Hübner, Susanne Isfort, Bernd Kasper, Alexander Katalinic, Angelika Kestler, Yascha Khodamoradi, Johannes Kleemann, Luis A. Kluth, Viktoria F. Köhler, Otto Kollmar, Steffen Koschmieder, Fabian Lang, Philipp Makowka, Peter Mallmann, Nina Mallmann-Gottschalk, Philipp Mandel, Gabriele Maurer, Arnulf Mayer, Markus Meissner, Franka Menge, Jan Moritz Middeke, Wolfgang Miesbach, Markus Möhler, Volker Möbus, Stefan C. Müller, Thomas J. Musholt, Friedemann Nauck, Thomas Oellerich, Deniz Özistanbullu, Rainer Porschen, Christian Pox, Konrad Klaus Richter, Tilman Sauerbruch, Sebastian Scheich, Johannes Schetelig, Heinz Schmidberger, Hans-Georg Schnürch, Martin Sebastian, Jalid Sehouli, Ulf Seifart, Hubert Serve, Thomas Seufferlein, Shabnam Shaid, Savas D. Soysal, Björn Steffen, Joachim P. Steinbach, Jan A. Stratmann, Ioannis Tsoukakis, Evelyn Ullrich, Janne Vehreschild, Ivana von Metzler, Michael von Wolff, Martin Voß, Sebastian Wagner, Matthias M. Weber, Henning Wege, Joachim Weis, Maria-Noemi Welte, Mike Wenzel, Timo Wolf, and David Zurmeyer

Published
2022

10. Dünndarm

Author

Margret Alm, Viola Andresen, Christian Ell, Christiane Fibbe, Wolfgang Fischbach, Jutta Keller, PH. Frank Kipp, Andrea May, Stephan Miehlke, Rainer Porschen, Andreas Stallmach, Thomas Weinke, Niklas Aehling, Daniel C. Baumgart, Franziska Bertram, Albrecht Böhlig, Catharina Bullmann, Johanna Carstensen, Marie de Greck, Wienke Ellerbeck, Giulia Enders, Korinna Fritz, Antonia Gaus, Laura Gottschalk, Kai Daniel Grandt, Utah-Maria Henniges, Toni Herta, Dorothea Jasper, Nina Kschowak, Konstantin Lang, Alina Lange, Peter Layer, Niels Liedtke, Janek Luttermann, Lida Mancke, Viola Sophie Meier, Ulrike Melle, Daniela Menge, Stefan Michaelis, Sara Nader, Tim-Alexander Niedergassel, Carsten Pachmann, Solveig Rose, Ulrich Rosien, Martin Rössle, Melina Schellhorn, Oliver Schnell, Sebastian Schulz, Julian Siegel, Alexander Stein, Johannes Szuba, Sarah Teising, Stephanie Thiel, Julia Thomas-Morr, Henriette Tillmann, Friederike Todt, Rhea Veelken, Henrike von Schassen, Michael Wölfel, Susanna Wolf, Valentin Wolgast, Clara Wübbolding, and Kathrin Zimmermann

Published
2021

11. Infektiöse Darmerkrankungen

Author

Margret Alm, Viola Andresen, Christian Ell, Christiane Fibbe, Wolfgang Fischbach, Jutta Keller, PH. Frank Kipp, Andrea May, Stephan Miehlke, Rainer Porschen, Andreas Stallmach, Thomas Weinke, Niklas Aehling, Daniel C. Baumgart, Franziska Bertram, Albrecht Böhlig, Catharina Bullmann, Johanna Carstensen, Marie de Greck, Wienke Ellerbeck, Giulia Enders, Korinna Fritz, Antonia Gaus, Laura Gottschalk, Kai Daniel Grandt, Utah-Maria Henniges, Toni Herta, Dorothea Jasper, Nina Kschowak, Konstantin Lang, Alina Lange, Peter Layer, Niels Liedtke, Janek Luttermann, Lida Mancke, Viola Sophie Meier, Ulrike Melle, Daniela Menge, Stefan Michaelis, Sara Nader, Tim-Alexander Niedergassel, Carsten Pachmann, Solveig Rose, Ulrich Rosien, Martin Rössle, Melina Schellhorn, Oliver Schnell, Sebastian Schulz, Julian Siegel, Alexander Stein, Johannes Szuba, Sarah Teising, Stephanie Thiel, Julia Thomas-Morr, Henriette Tillmann, Friederike Todt, Rhea Veelken, Henrike von Schassen, Michael Wölfel, Susanna Wolf, Valentin Wolgast, Clara Wübbolding, and Kathrin Zimmermann

Published
2021

12. Magen und Duodenum

Author

Margret Alm, Viola Andresen, Christian Ell, Christiane Fibbe, Wolfgang Fischbach, Jutta Keller, PH. Frank Kipp, Andrea May, Stephan Miehlke, Rainer Porschen, Andreas Stallmach, Thomas Weinke, Niklas Aehling, Daniel C. Baumgart, Franziska Bertram, Albrecht Böhlig, Catharina Bullmann, Johanna Carstensen, Marie de Greck, Wienke Ellerbeck, Giulia Enders, Korinna Fritz, Antonia Gaus, Laura Gottschalk, Kai Daniel Grandt, Utah-Maria Henniges, Toni Herta, Dorothea Jasper, Nina Kschowak, Konstantin Lang, Alina Lange, Peter Layer, Niels Liedtke, Janek Luttermann, Lida Mancke, Viola Sophie Meier, Ulrike Melle, Daniela Menge, Stefan Michaelis, Sara Nader, Tim-Alexander Niedergassel, Carsten Pachmann, Solveig Rose, Ulrich Rosien, Martin Rössle, Melina Schellhorn, Oliver Schnell, Sebastian Schulz, Julian Siegel, Alexander Stein, Johannes Szuba, Sarah Teising, Stephanie Thiel, Julia Thomas-Morr, Henriette Tillmann, Friederike Todt, Rhea Veelken, Henrike von Schassen, Michael Wölfel, Susanna Wolf, Valentin Wolgast, Clara Wübbolding, and Kathrin Zimmermann

Subjects
business.industry, Medicine, business
Published
2021

14. Autoren

Author

Salah-Eddin Al-Batran, Hans-Dieter Allescher, Beate Appenrodt, Stefan Aretz, Ulrike von Arnim, Ulrich Beuers, Georg Beyer, Christoph Boesecke, Fanny Borowitzka, Karel Caca, Carolin Czauderna, Carola Dröge, Franz Ludwig Dumoulin, Hans-Jörg Epple, Gerhard E. Feurle, Christiane Fibbe, Wolfgang Fischbach, Thomas Frieling, Peter R. Galle, Christoph-Thomas Germer, Maria A. Gonzalez-Carmona, Thorsten Oliver Götze, Felix Gundling, Emina Halilbasic, Franz Hartmann, Alexander Herold, Toni Herta, Jörg Höllerich, Wolfgang Holtmeier, Thomas Horvatits, Robert Hüneburg, Christoph Jüngst, Jörg C. Kalff, Jennis Kandler, Verena Keitel-Anselmino, Jutta Keller, Angelika Kestler, Marlies Köpke, Sibylle Koletzko, Otto Kollmar, Heiner Krammer, Ilja Kubisch, Wolfgang Kruis, Gerd A. Kullak-Ublick, Joachim Labenz, Frank Lammert, Georg Lamprecht, Peter Layer, Ludger Leifeld, Norbert Lügering, Philipp L. Lutz, Peter Malfertheiner, Julia Mayerle, Benjamin Meier, Uta Merle, Markus Möhler, Stefan Müller-Lissner, Petra Munda, Michael Neubrand, Horst Neuhaus, Christian Pehl, Sven Pischke, Rainer Porschen, Christian Pox, Rafique Rahimzai, Martin Raithel, Jürgen Rockstroh, Elke Roeb, Christoph Sarrazin, Tilman Sauerbruch, Michael Schepke, Wolfgang Schepp, Katharina Scheyda, Annika Schmitt, Christian Schulz, Detlef Schuppan, Thomas Seufferlein, Britta Siegmund, Simon Sirtl, Savas D. Soysal, Ulrich Spengler, Andreas Stallmach, Thomas Stauch, Jan Stindt, Ulrich Stölzel, Christian P. Strassburg, Frank Tacke, Birgit Terjung, Michael Trauner, Jonel Trebicka, Hanno Tröger, Henning Wege, Tobias J. Weismüller, and Susanna Wolf

Published
2021

15. Diagnostische und therapeutische Verfahren

Author

Margret Alm, Viola Andresen, Christian Ell, Christiane Fibbe, Wolfgang Fischbach, Jutta Keller, PH. Frank Kipp, Andrea May, Stephan Miehlke, Rainer Porschen, Andreas Stallmach, Thomas Weinke, Niklas Aehling, Daniel C. Baumgart, Franziska Bertram, Albrecht Böhlig, Catharina Bullmann, Johanna Carstensen, Marie de Greck, Wienke Ellerbeck, Giulia Enders, Korinna Fritz, Antonia Gaus, Laura Gottschalk, Kai Daniel Grandt, Utah-Maria Henniges, Toni Herta, Dorothea Jasper, Nina Kschowak, Konstantin Lang, Alina Lange, Peter Layer, Niels Liedtke, Janek Luttermann, Lida Mancke, Viola Sophie Meier, Ulrike Melle, Daniela Menge, Stefan Michaelis, Sara Nader, Tim-Alexander Niedergassel, Carsten Pachmann, Solveig Rose, Ulrich Rosien, Martin Rössle, Melina Schellhorn, Oliver Schnell, Sebastian Schulz, Julian Siegel, Alexander Stein, Johannes Szuba, Sarah Teising, Stephanie Thiel, Julia Thomas-Morr, Henriette Tillmann, Friederike Todt, Rhea Veelken, Henrike von Schassen, Michael Wölfel, Susanna Wolf, Valentin Wolgast, Clara Wübbolding, and Kathrin Zimmermann

Subjects
business.industry, Medicine, business
Published
2021

16. Proktologische Erkrankungen

Author

Margret Alm, Viola Andresen, Christian Ell, Christiane Fibbe, Wolfgang Fischbach, Jutta Keller, PH. Frank Kipp, Andrea May, Stephan Miehlke, Rainer Porschen, Andreas Stallmach, Thomas Weinke, Niklas Aehling, Daniel C. Baumgart, Franziska Bertram, Albrecht Böhlig, Catharina Bullmann, Johanna Carstensen, Marie de Greck, Wienke Ellerbeck, Giulia Enders, Korinna Fritz, Antonia Gaus, Laura Gottschalk, Kai Daniel Grandt, Utah-Maria Henniges, Toni Herta, Dorothea Jasper, Nina Kschowak, Konstantin Lang, Alina Lange, Peter Layer, Niels Liedtke, Janek Luttermann, Lida Mancke, Viola Sophie Meier, Ulrike Melle, Daniela Menge, Stefan Michaelis, Sara Nader, Tim-Alexander Niedergassel, Carsten Pachmann, Solveig Rose, Ulrich Rosien, Martin Rössle, Melina Schellhorn, Oliver Schnell, Sebastian Schulz, Julian Siegel, Alexander Stein, Johannes Szuba, Sarah Teising, Stephanie Thiel, Julia Thomas-Morr, Henriette Tillmann, Friederike Todt, Rhea Veelken, Henrike von Schassen, Michael Wölfel, Susanna Wolf, Valentin Wolgast, Clara Wübbolding, and Kathrin Zimmermann

Published
2021

17. Pankreas

Author

Margret Alm, Viola Andresen, Christian Ell, Christiane Fibbe, Wolfgang Fischbach, Jutta Keller, PH. Frank Kipp, Andrea May, Stephan Miehlke, Rainer Porschen, Andreas Stallmach, Thomas Weinke, Niklas Aehling, Daniel C. Baumgart, Franziska Bertram, Albrecht Böhlig, Catharina Bullmann, Johanna Carstensen, Marie de Greck, Wienke Ellerbeck, Giulia Enders, Korinna Fritz, Antonia Gaus, Laura Gottschalk, Kai Daniel Grandt, Utah-Maria Henniges, Toni Herta, Dorothea Jasper, Nina Kschowak, Konstantin Lang, Alina Lange, Peter Layer, Niels Liedtke, Janek Luttermann, Lida Mancke, Viola Sophie Meier, Ulrike Melle, Daniela Menge, Stefan Michaelis, Sara Nader, Tim-Alexander Niedergassel, Carsten Pachmann, Solveig Rose, Ulrich Rosien, Martin Rössle, Melina Schellhorn, Oliver Schnell, Sebastian Schulz, Julian Siegel, Alexander Stein, Johannes Szuba, Sarah Teising, Stephanie Thiel, Julia Thomas-Morr, Henriette Tillmann, Friederike Todt, Rhea Veelken, Henrike von Schassen, Michael Wölfel, Susanna Wolf, Valentin Wolgast, Clara Wübbolding, and Kathrin Zimmermann

Published
2021

18. Besondere Störungen

Author

Margret Alm, Viola Andresen, Christian Ell, Christiane Fibbe, Wolfgang Fischbach, Jutta Keller, PH. Frank Kipp, Andrea May, Stephan Miehlke, Rainer Porschen, Andreas Stallmach, Thomas Weinke, Niklas Aehling, Daniel C. Baumgart, Franziska Bertram, Albrecht Böhlig, Catharina Bullmann, Johanna Carstensen, Marie de Greck, Wienke Ellerbeck, Giulia Enders, Korinna Fritz, Antonia Gaus, Laura Gottschalk, Kai Daniel Grandt, Utah-Maria Henniges, Toni Herta, Dorothea Jasper, Nina Kschowak, Konstantin Lang, Alina Lange, Peter Layer, Niels Liedtke, Janek Luttermann, Lida Mancke, Viola Sophie Meier, Ulrike Melle, Daniela Menge, Stefan Michaelis, Sara Nader, Tim-Alexander Niedergassel, Carsten Pachmann, Solveig Rose, Ulrich Rosien, Martin Rössle, Melina Schellhorn, Oliver Schnell, Sebastian Schulz, Julian Siegel, Alexander Stein, Johannes Szuba, Sarah Teising, Stephanie Thiel, Julia Thomas-Morr, Henriette Tillmann, Friederike Todt, Rhea Veelken, Henrike von Schassen, Michael Wölfel, Susanna Wolf, Valentin Wolgast, Clara Wübbolding, and Kathrin Zimmermann

Published
2021

19. Gastroenterologische Notfälle und Leitsymptome

Author

Margret Alm, Viola Andresen, Christian Ell, Christiane Fibbe, Wolfgang Fischbach, Jutta Keller, PH. Frank Kipp, Andrea May, Stephan Miehlke, Rainer Porschen, Andreas Stallmach, Thomas Weinke, Niklas Aehling, Daniel C. Baumgart, Franziska Bertram, Albrecht Böhlig, Catharina Bullmann, Johanna Carstensen, Marie de Greck, Wienke Ellerbeck, Giulia Enders, Korinna Fritz, Antonia Gaus, Laura Gottschalk, Kai Daniel Grandt, Utah-Maria Henniges, Toni Herta, Dorothea Jasper, Nina Kschowak, Konstantin Lang, Alina Lange, Peter Layer, Niels Liedtke, Janek Luttermann, Lida Mancke, Viola Sophie Meier, Ulrike Melle, Daniela Menge, Stefan Michaelis, Sara Nader, Tim-Alexander Niedergassel, Carsten Pachmann, Solveig Rose, Ulrich Rosien, Martin Rössle, Melina Schellhorn, Oliver Schnell, Sebastian Schulz, Julian Siegel, Alexander Stein, Johannes Szuba, Sarah Teising, Stephanie Thiel, Julia Thomas-Morr, Henriette Tillmann, Friederike Todt, Rhea Veelken, Henrike von Schassen, Michael Wölfel, Susanna Wolf, Valentin Wolgast, Clara Wübbolding, and Kathrin Zimmermann

Subjects
business.industry, Medicine, business
Published
2021

20. Risikomanagement in der Gastroenterologie

Author

Margret Alm, Viola Andresen, Christian Ell, Christiane Fibbe, Wolfgang Fischbach, Jutta Keller, PH. Frank Kipp, Andrea May, Stephan Miehlke, Rainer Porschen, Andreas Stallmach, Thomas Weinke, Niklas Aehling, Daniel C. Baumgart, Franziska Bertram, Albrecht Böhlig, Catharina Bullmann, Johanna Carstensen, Marie de Greck, Wienke Ellerbeck, Giulia Enders, Korinna Fritz, Antonia Gaus, Laura Gottschalk, Kai Daniel Grandt, Utah-Maria Henniges, Toni Herta, Dorothea Jasper, Nina Kschowak, Konstantin Lang, Alina Lange, Peter Layer, Niels Liedtke, Janek Luttermann, Lida Mancke, Viola Sophie Meier, Ulrike Melle, Daniela Menge, Stefan Michaelis, Sara Nader, Tim-Alexander Niedergassel, Carsten Pachmann, Solveig Rose, Ulrich Rosien, Martin Rössle, Melina Schellhorn, Oliver Schnell, Sebastian Schulz, Julian Siegel, Alexander Stein, Johannes Szuba, Sarah Teising, Stephanie Thiel, Julia Thomas-Morr, Henriette Tillmann, Friederike Todt, Rhea Veelken, Henrike von Schassen, Michael Wölfel, Susanna Wolf, Valentin Wolgast, Clara Wübbolding, and Kathrin Zimmermann

Published
2021

21. Kolon

Author

Margret Alm, Viola Andresen, Christian Ell, Christiane Fibbe, Wolfgang Fischbach, Jutta Keller, PH. Frank Kipp, Andrea May, Stephan Miehlke, Rainer Porschen, Andreas Stallmach, Thomas Weinke, Niklas Aehling, Daniel C. Baumgart, Franziska Bertram, Albrecht Böhlig, Catharina Bullmann, Johanna Carstensen, Marie de Greck, Wienke Ellerbeck, Giulia Enders, Korinna Fritz, Antonia Gaus, Laura Gottschalk, Kai Daniel Grandt, Utah-Maria Henniges, Toni Herta, Dorothea Jasper, Nina Kschowak, Konstantin Lang, Alina Lange, Peter Layer, Niels Liedtke, Janek Luttermann, Lida Mancke, Viola Sophie Meier, Ulrike Melle, Daniela Menge, Stefan Michaelis, Sara Nader, Tim-Alexander Niedergassel, Carsten Pachmann, Solveig Rose, Ulrich Rosien, Martin Rössle, Melina Schellhorn, Oliver Schnell, Sebastian Schulz, Julian Siegel, Alexander Stein, Johannes Szuba, Sarah Teising, Stephanie Thiel, Julia Thomas-Morr, Henriette Tillmann, Friederike Todt, Rhea Veelken, Henrike von Schassen, Michael Wölfel, Susanna Wolf, Valentin Wolgast, Clara Wübbolding, and Kathrin Zimmermann

Published
2021

22. Chronisch-entzündliche Darmerkrankungen (CED)

Author

Margret Alm, Viola Andresen, Christian Ell, Christiane Fibbe, Wolfgang Fischbach, Jutta Keller, PH. Frank Kipp, Andrea May, Stephan Miehlke, Rainer Porschen, Andreas Stallmach, Thomas Weinke, Niklas Aehling, Daniel C. Baumgart, Franziska Bertram, Albrecht Böhlig, Catharina Bullmann, Johanna Carstensen, Marie de Greck, Wienke Ellerbeck, Giulia Enders, Korinna Fritz, Antonia Gaus, Laura Gottschalk, Kai Daniel Grandt, Utah-Maria Henniges, Toni Herta, Dorothea Jasper, Nina Kschowak, Konstantin Lang, Alina Lange, Peter Layer, Niels Liedtke, Janek Luttermann, Lida Mancke, Viola Sophie Meier, Ulrike Melle, Daniela Menge, Stefan Michaelis, Sara Nader, Tim-Alexander Niedergassel, Carsten Pachmann, Solveig Rose, Ulrich Rosien, Martin Rössle, Melina Schellhorn, Oliver Schnell, Sebastian Schulz, Julian Siegel, Alexander Stein, Johannes Szuba, Sarah Teising, Stephanie Thiel, Julia Thomas-Morr, Henriette Tillmann, Friederike Todt, Rhea Veelken, Henrike von Schassen, Michael Wölfel, Susanna Wolf, Valentin Wolgast, Clara Wübbolding, and Kathrin Zimmermann

Subjects
business.industry, Medicine, business
Published
2021

23. Ösophagus

Author

Margret Alm, Viola Andresen, Christian Ell, Christiane Fibbe, Wolfgang Fischbach, Jutta Keller, PH. Frank Kipp, Andrea May, Stephan Miehlke, Rainer Porschen, Andreas Stallmach, Thomas Weinke, Niklas Aehling, Daniel C. Baumgart, Franziska Bertram, Albrecht Böhlig, Catharina Bullmann, Johanna Carstensen, Marie de Greck, Wienke Ellerbeck, Giulia Enders, Korinna Fritz, Antonia Gaus, Laura Gottschalk, Kai Daniel Grandt, Utah-Maria Henniges, Toni Herta, Dorothea Jasper, Nina Kschowak, Konstantin Lang, Alina Lange, Peter Layer, Niels Liedtke, Janek Luttermann, Lida Mancke, Viola Sophie Meier, Ulrike Melle, Daniela Menge, Stefan Michaelis, Sara Nader, Tim-Alexander Niedergassel, Carsten Pachmann, Solveig Rose, Ulrich Rosien, Martin Rössle, Melina Schellhorn, Oliver Schnell, Sebastian Schulz, Julian Siegel, Alexander Stein, Johannes Szuba, Sarah Teising, Stephanie Thiel, Julia Thomas-Morr, Henriette Tillmann, Friederike Todt, Rhea Veelken, Henrike von Schassen, Michael Wölfel, Susanna Wolf, Valentin Wolgast, Clara Wübbolding, and Kathrin Zimmermann

Published
2021

24. Leber

Author

Margret Alm, Viola Andresen, Christian Ell, Christiane Fibbe, Wolfgang Fischbach, Jutta Keller, PH. Frank Kipp, Andrea May, Stephan Miehlke, Rainer Porschen, Andreas Stallmach, Thomas Weinke, Niklas Aehling, Daniel C. Baumgart, Franziska Bertram, Albrecht Böhlig, Catharina Bullmann, Johanna Carstensen, Marie de Greck, Wienke Ellerbeck, Giulia Enders, Korinna Fritz, Antonia Gaus, Laura Gottschalk, Kai Daniel Grandt, Utah-Maria Henniges, Toni Herta, Dorothea Jasper, Nina Kschowak, Konstantin Lang, Alina Lange, Peter Layer, Niels Liedtke, Janek Luttermann, Lida Mancke, Viola Sophie Meier, Ulrike Melle, Daniela Menge, Stefan Michaelis, Sara Nader, Tim-Alexander Niedergassel, Carsten Pachmann, Solveig Rose, Ulrich Rosien, Martin Rössle, Melina Schellhorn, Oliver Schnell, Sebastian Schulz, Julian Siegel, Alexander Stein, Johannes Szuba, Sarah Teising, Stephanie Thiel, Julia Thomas-Morr, Henriette Tillmann, Friederike Todt, Rhea Veelken, Henrike von Schassen, Michael Wölfel, Susanna Wolf, Valentin Wolgast, Clara Wübbolding, and Kathrin Zimmermann

Published
2021

25. Acute sedation-associated complications in GI endoscopy (ProSed 2 Study): results from the prospective multicentre electronic registry of sedation-associated complications

Author

Irmtraut Koop, Gernot Kaiser, Alexander Krannich, Ralf Kiesslich, Jens Kuehne, Frank Kullmann, Martin Balsliemke, G. Kleber, Sonja Pampuch, Anton Kreuzmayr, Christian de Mas, Olaf Engelke, Albrecht Lorenz, Franz Ludwig Dumoulin, Axel Dignass, Stephan Boehm, Dieter Schilling, Oliver Pech, Thomas Rabenstein, Nils Lennart Sass, Werner Schmidbaur, Georg Haltern, Dieter Schwab, Joachim F Erckenbrecht, Werner Hoffmann, Michael Sackmann, Christian von Tirpitz, Claus Benz, Claus Schaefer, Volker Schmitz, Herbert Koop, Angelika Behrens, Hendrik Manner, Nico Barteska, Markus Dollhopf, Wolfgang Schmitt, Christian Friedrich, Alexander Arlt, Christian Ell, Mark Ellrichmann, Ronni Veitt, Matthias Breidert, Berthold Lenfers, Marcus Ewald, Christian Pehl, J Labenz, Rainer Porschen, Vito Cicinnati, Susanne Beckebaum, Martin Krüger, Uwe Weickert, Wolfgang Fischbach, Mathais Plauth, Wanja Renner, Andrea May, Jens-Uwe Jetschmann, and Christoph Vogt

Subjects
Adult, Male, 0301 basic medicine, Time Factors, Multivariate analysis, Adolescent, Referral, Sedation, Conscious Sedation, Endoscopy, Gastrointestinal, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Germany, Humans, Hypnotics and Sedatives, Medicine, Prospective Studies, Registries, Child, Propofol, Aged, Aged, 80 and over, medicine.diagnostic_test, business.industry, Infant, Newborn, Gastroenterology, Infant, Middle Aged, Endoscopy, Regimen, 030104 developmental biology, Child, Preschool, Anesthesia, Acute Disease, Midazolam, Female, 030211 gastroenterology & hepatology, medicine.symptom, business, Complication, medicine.drug
Abstract

ObjectivesSedation has been established for GI endoscopic procedures in most countries, but it is also associated with an added risk of complications. Reported complication rates are variable due to different study methodologies and often limited sample size.DesignsAcute sedation-associated complications were prospectively recorded in an electronic endoscopy documentation in 39 study centres between December 2011 and August 2014 (median inclusion period 24 months). The sedation regimen was decided by each study centre.ResultsA total of 368 206 endoscopies was recorded; 11% without sedation. Propofol was the dominant drug used (62% only, 22.5% in combination with midazolam). Of the sedated patients, 38 (0.01%) suffered a major complication, and overall mortality was 0.005% (n=15); minor complications occurred in 0.3%. Multivariate analysis showed the following independent risk factors for all complications: American Society of Anesthesiologists class >2 (OR 2.29) and type and duration of endoscopy. Of the sedation regimens, propofol monosedation had the lowest rate (OR 0.75) compared with midazolam (reference) and combinations (OR 1.0–1.5). Compared with primary care hospitals, tertiary referral centres had higher complication rates (OR 1.61). Notably, compared with sedation by a two-person endoscopy team (endoscopist/assistant; 53.5% of all procedures), adding another person for sedation (nurse, physician) was associated with higher complication rates (ORs 1.40–4.46), probably due to higher complexity of procedures not evident in the multivariate analysis.ConclusionsThis large multicentre registry study confirmed that severe acute sedation-related complications are rare during GI endoscopy with a very low mortality. The data are useful for planning risk factor-adapted sedation management to further prevent sedation-associated complications in selected patients.Trial registration numberDRKS00007768; Pre-results.

Published
2018

26. Outcome according to KRAS-, NRAS- and BRAF-mutation as well as KRAS mutation variants: pooled analysis of five randomized trials in metastatic colorectal cancer by the AIO colorectal cancer study group

Author

L.F. von Weikersthal, U. Graeven, Thomas Kirchner, Clemens Giessen-Jung, W. Schmiegel, Rainer Porschen, Dominik Paul Modest, S. Hegewisch-Becker, Andrea Tannapfel, Anke Reinacher-Schick, H.-J. Schmoll, Arndt Stahler, Dirk Arnold, Sebastian Stintzing, Ingrid Ricard, Andreas Jung, and Volker Heinemann

Subjects
Male, Proto-Oncogene Proteins B-raf, 0301 basic medicine, Neuroblastoma RAS viral oncogene homolog, Oncology, medicine.medical_specialty, endocrine system diseases, Colorectal cancer, colorectal cancer, Kaplan-Meier Estimate, medicine.disease_cause, Disease-Free Survival, BRAF, GTP Phosphohydrolases, law.invention, Proto-Oncogene Proteins p21(ras), 03 medical and health sciences, Exon, 0302 clinical medicine, Randomized controlled trial, law, Internal medicine, Gastrointestinal Tumors, Humans, Medicine, Neoplasm Metastasis, prognostic factor, neoplasms, Randomized Controlled Trials as Topic, Proportional hazards model, business.industry, Hazard ratio, Membrane Proteins, Original Articles, Hematology, medicine.disease, digestive system diseases, respiratory tract diseases, Treatment Outcome, 030104 developmental biology, 030220 oncology & carcinogenesis, Mutation, Mutation (genetic algorithm), Female, KRAS, Colorectal Neoplasms, business, RAS
Abstract

In this pooled analysis of metastatic colorectal cancer patients, mutations in KRAS, and BRAF were associated with inferior progression-free and overall survival compared with patients with non-mutated tumors. KRAS exon 2 mutation variants were associated with heterogeneous outcome compared with unmutated tumors with KRAS G12C and G13D being associated with rather poor survival., Background To explore the impact of KRAS, NRAS and BRAF mutations as well as KRAS mutation variants in patients with metastatic colorectal cancer (mCRC) receiving first-line therapy. Patients and methods A total of 1239 patients from five randomized trials (FIRE-1, FIRE-3, AIOKRK0207, AIOKRK0604, RO91) were included into the analysis. Outcome was evaluated by the Kaplan–Meier method, log-rank tests and Cox models. Results In 664 tumors, no mutation was detected, 462 tumors were diagnosed with KRAS-, 39 patients with NRAS- and 74 patients with BRAF-mutation. Mutations in KRAS were associated with inferior progression-free survival (PFS) and overall survival (OS) [multivariate hazard ratio (HR) for PFS: 1.20 (1.02–1.42), P = 0.03; multivariate HR for OS: 1.41 (1.17–1.70), P < 0.001]. BRAF mutation was also associated with inferior PFS [multivariate HR: 2.19 (1.59–3.02), P < 0.001] and OS [multivariate HR: 2.99 (2.10–4.25), P < 0.001]. Among specific KRAS mutation variants, the KRAS G12C-variant (n = 28) correlated with inferior OS compared with unmutated tumors [multivariate HR 2.26 (1.25–4.1), P = 0.001]. A similar trend for OS was seen in the KRAS G13D-variant [n = 71, multivariate HR 1.46 (0.96–2.22), P = 0.10]. More frequent KRAS exon 2 variants like G12D [n = 152, multivariate HR 1.17 (0.86–1.6), P = 0.81] and G12V [n = 92, multivariate HR 1.27 (0.87–1.86), P = 0.57] did not have significant impact on OS. Conclusion Mutations in KRAS and BRAF were associated with inferior PFS and OS of mCRC patients compared with patients with non-mutated tumors. KRAS exon 2 mutation variants were associated with heterogeneous outcome compared with unmutated tumors with KRAS G12C and G13D (trend) being associated with rather poor survival.

Published
2016

28. Adressen

Author

Peter Layer, Ulrich Rosien, Margret Alm, Viola Andresen, Daniel C. Baumgart, Angelika Behrens, Thomas Berg, Franziska Bertram, Michael Bläker, Anja Buchholtz, Catharina Bullmann, Marie de Greck, Christian Ell, Wienke Ellerbeck, Dorothea Frederking, Christiane Fibbe, Wolfgang Fischbach, Antonia Gaus, Janine Gehrs, Daniel Grandt, Jennifer Haensel, Utah-Maria Henniges, Dorothea Jasper, Annabelle Jung, Beate Keck, Jutta Keller, Frank Kipp, Alina Lange, Niels Liedtke, Florian Lordick, Dietmar Lorenz, Lida V. Mancke, Viola Sophie Meier, Ulrike Melle, Daniela Menge, Helmut Messmann, Stefan Michaelis, Stephan Miehlke, Andreas Müller, Sara Nader, Tim-Alexander Niedergassel, Katrin Niemax, Carsten Pachmann, Rainer Porschen, Sarah Romberg, Solveig Rose, Jil K. Schneider-Affeld, Sebastian Schulz, Wolfgang Schwarz, Arno Siebenhaar, Julian Siegel, Andreas Stallmach, Johannes Szuba, Sarah Teising, Stephanie Thiel, Julia Thomas-Morr, Henriette Tillmann, Friederike Todt, Christian Trautwein, Korinna Ulbricht, Henrike von Schassen, Thomas Weinke, and Hubert Zirngibl

Published
2018

29. Personalizing Survival Predictions in Advanced Colorectal Cancer: The ARCAD Nomogram Project

Author

Tim Maughan, Rainer Porschen, Cornelis J. A. Punt, Eduardo Díaz-Rubio, Leonard B. Saltz, Miriam Koopman, Daniel J. Sargent, Volker Heinemann, Niall C. Tebbutt, Eric Van Cutsem, John Zalcberg, Alfredo Falcone, Lindsay A. Renfro, Benoist Chibaudel, Hans-Joachim Schmoll, R. John Simes, Enrique Aranda, Richard Adams, Jean-Yves Douillard, Paulo M. Hoff, J. R. Hecht, Aimery de Gramont, Katrin Marie Sjoquist, Jeffrey P. Meyers, Ioannis Souglakos, Richard M. Goldberg, Herbert Hurwitz, Charles S. Fuchs, Fairooz F. Kabbinavar, Carsten Bokemeyer, Christophe Tournigand, Stephen Clarke, Matthew T. Seymour, Oncology, CCA - Cancer Treatment and Quality of Life, and (Arcad), Fondation Aide Et Recherche En Cancerologie Digestive Group

Subjects
0301 basic medicine, Oncology, Male, medicine.medical_specialty, Cancer Research, Colorectal cancer, Oncology and Carcinogenesis, MÉDICOS, 03 medical and health sciences, 0302 clinical medicine, Clinical Research, Internal medicine, Medicine, Humans, Oncology & Carcinogenesis, Progression-free survival, Neoplasm Metastasis, Precision Medicine, Survival analysis, Cancer, Aged, Fondation Aide et Recherche en Cancerologie Digestive Group, Performance status, business.industry, Proportional hazards model, Prevention, Articles, Nomogram, Middle Aged, medicine.disease, Prognosis, Survival Analysis, Neoadjuvant Therapy, Progression-Free Survival, Colo-Rectal Cancer, Clinical trial, Nomograms, 030104 developmental biology, 030220 oncology & carcinogenesis, Absolute neutrophil count, Disease Progression, Female, Patient Safety, Digestive Diseases, business, Colorectal Neoplasms
Abstract

Background:Estimating prognosis on the basis of clinicopathologic factors can inform clinical practice and improve risk stratification for clinical trials. We constructed prognostic nomograms for one-year overall survival and six-month progression-free survival in metastatic colorectal carcinoma by using the ARCAD database. Methods:Data from 22 674 patients in 26 randomized phase III clinical trials since 1997 were used to construct and validate Cox models, stratified by treatment arm within each study. Candidate variables included baseline age, sex, body mass index, performance status, colon vs rectal cancer, prior chemotherapy, number and location of metastatic sites, tumor mutation status (BRAF, KRAS), bilirubin, albumin, white blood cell count, hemoglobin, platelets, absolute neutrophil count, and derived neutrophil-to-lymphocyte ratio. Missing data (50% vs 50% vs

Published
2017

30. S3-Leitlinie Diagnostik und Therapie der Plattenepithelkarzinome und Adenokarzinome des Ösophagus (Langversion 1.0 – September 2015, AWMF-Registernummer: 021/023OL)

Author

Ines Gockel, Martin Stuschke, Markus Möhler, Hans-Joachim Meyer, Arnulf H. Hölscher, J. Körber, U. Pech, Wolfgang Fischbach, Frederik Wenz, Arved Weimann, U. Nöthlings, M. Schmidt, Stephan Miehlke, Peter C. Thuss-Patience, A. Buck, Stephan Hollerbach, Rainer Porschen, Heinz Schmidberger, C. Wullstein, Udo Vanhoefer, Michael Stahl, Lars Grenacher, U. Görling, Helmut Messmann, and Joerg Trojan

Subjects
Gynecology, medicine.medical_specialty, business.industry, Medizin, Gastroenterology, Medicine, business
Abstract

1. Informationen zu dieser Leitlinie 1289 1.1. Herausgeber 1289 1.2. Federfuhrende Fachgesellschaft 1289 1.3. Finanzierung der Leitlinie 1289 1.4. Kontakt 1289 1.5. Zitierweise 1289 1.6. Besonderer Hinweis 1289 1.7. Ziele des Leitlinienprogramms Onkologie 1289 1.8. Weitere Dokumente zu dieser Leitlinie 1289 1.9. Zusammensetzung der Leitliniengruppe 1290 1.9.1. Leitlinienkoordination 1290 1.9.2. Autoren der Leitlinie 1290 1.9.3. Beteiligte Fachgesellschaften und Organisationen 1290

Published
2015

31. Individual Patient Data Analysis of Progression-Free Survival Versus Overall Survival As a First-Line End Point for Metastatic Colorectal Cancer in Modern Randomized Trials: Findings From the Analysis and Research in Cancers of the Digestive System Database

Author

Christophe Tournigand, Daniel J. Sargent, Axel Grothey, Volker Heinemann, Herbert Hurwitz, Marc Buyse, Hans-Joachim Schmoll, Richard M. Goldberg, Charles S. Fuchs, Jean-Yves Douillard, Carsten Bokemeyer, J. R. Hecht, Richard Adams, Leonard B. Saltz, Niall C. Tebbutt, Fairooz F. Kabbinavar, John Souglakos, Eduardo Díaz-Rubio, Alfredo Falcone, Aimery de Gramont, Rainer Porschen, Matthew T. Seymour, Paulo M. Hoff, Qian Shi, Cornelis J. A. Punt, John Zalcberg, Eric Van Cutsem, Benoist Chibaudel, CCA -Cancer Center Amsterdam, and Oncology

Subjects
Oncology, Cancer Research, Biomedical Research, Databases, Factual, Outcome Assessment, Colorectal cancer, Angiogenesis Inhibitors, law.invention, Randomized controlled trial, law, Neoplasms, Antineoplastic Combined Chemotherapy Protocols, Outcome Assessment, Health Care, 80 and over, Neoplasm Metastasis, Young adult, Randomized Controlled Trials as Topic, Cancer, Aged, 80 and over, ORIGINAL REPORTS, Middle Aged, Prognosis, Colo-Rectal Cancer, ErbB Receptors, 6.1 Pharmaceuticals, Colorectal Neoplasms, Receptor, Adult, medicine.medical_specialty, First line, Clinical Trials and Supportive Activities, Clinical Sciences, Oncology and Carcinogenesis, Antineoplastic Agents, Disease-Free Survival, Outcome Assessment (Health Care), Databases, Young Adult, Clinical Trials, Phase II as Topic, Clinical Research, Internal medicine, medicine, Overall survival, Humans, Oncology & Carcinogenesis, Progression-free survival, Protein Kinase Inhibitors, Factual, Aged, Digestive System, Receptor, Epidermal Growth Factor, End point, Epidermal Growth Factor, business.industry, Evaluation of treatments and therapeutic interventions, Patient data, medicine.disease, digestive system diseases, Health Care, Clinical Trials, Phase III as Topic, Digestive Diseases, business
Abstract

Purpose Progression-free survival (PFS) has previously been established as a surrogate for overall survival (OS) for first-line metastatic colorectal cancer (mCRC). Because mCRC treatment has advanced in the last decade with extended OS, this surrogacy requires re-examination. Methods Individual patient data from 16,762 patients were available from 22 first-line mCRC studies conducted from 1997 to 2006; 12 of those studies tested antiangiogenic and/or anti–epidermal growth factor receptor agents. The relationship between PFS (first event of progression or death) and OS was evaluated by using R2 statistics (the closer the value is to 1, the stronger the correlation) from weighted least squares regression of trial-specific hazard ratios estimated by using Cox and Copula models. Results Forty-four percent of patients received a regimen that included biologic agents. Median first-line PFS was 8.3 months, and median OS was 18.2 months. The correlation between PFS and OS was modest (R2, 0.45 to 0.69). Analyses limited to trials that tested treatments with biologic agents, nonstrategy trials, or superiority trials did not improve surrogacy. Conclusion In modern mCRC trials, in which survival after the first progression exceeds time to first progression, a positive but modest correlation was observed between OS and PFS at both the patient and trial levels. This finding demonstrates the substantial variability in OS introduced by the number of lines of therapy and types of effective subsequent treatments and the associated challenge to the use of OS as an end point to assess the benefit attributable to a single line of therapy. PFS remains an appropriate primary end point for first-line mCRC trials to detect the direct treatment effect of new agents.

Published
2015

32. Clinical Calculator for Early Mortality in Metastatic Colorectal Cancer: An Analysis of Patients From 28 Clinical Trials in the Aide et Recherche en Cancérologie Digestive Database

Author

Alberto Sobrero, Hans-Joachim Schmoll, Cornelis J. A. Punt, Charles S. Fuchs, Paulo M. Hoff, Christophe Tournigand, Rainer Porschen, Jean-Yves Douillard, Axel Grothey, Richard M. Goldberg, Volker Heinemann, Eric Van Cutsem, Daniel J. Sargent, Carsten Bokemeyer, J. Randolph Hecht, Aimery de Gramont, Benoist Chibaudel, Herbert Hurwitz, Richard Adams, Alfredo Falcone, Lindsay A. Renfro, Niall C. Tebbutt, Fairooz F. Kabbinavar, Leonard B. Saltz, Matthew T. Seymour, John Souglakos, Eduardo Díaz-Rubio, CCA - Cancer Treatment and Quality of Life, Oncology, and Cancer Center Amsterdam

Subjects
0301 basic medicine, Male, Cancer Research, Colorectal cancer, computer.software_genre, Logistic regression, 03 medical and health sciences, 0302 clinical medicine, Medicine, Humans, Mass index, Clinical Trials, Aged, Randomized Controlled Trials as Topic, Performance status, Database, business.industry, Proportional hazards model, Mortality rate, Reproducibility of Results, ORIGINAL REPORTS, Nomogram, Middle Aged, medicine.disease, Clinical trial, Phase III as Topic, Nomograms, 030104 developmental biology, Logistic Models, Clinical Trials, Phase III as Topic, Oncology, 030220 oncology & carcinogenesis, Multivariate Analysis, Disease Progression, Female, business, Colorectal Neoplasms, computer
Abstract

Purpose Factors contributing to early mortality after initiation of treatment of metastatic colorectal cancer are poorly understood. Materials and Methods Data from 22,654 patients enrolled in 28 randomized phase III trials contained in the ARCAD (Aide et Recherche en Cancérologie Digestive) database were pooled. Multivariable logistic regression models for 30-, 60-, and 90-day mortality were constructed, including clinically and statistically significant patient and disease factors and interaction terms. A calculator (nomogram) for 90-day mortality was developed and validated internally using bootstrapping methods and externally using a 10% random holdout sample from each trial. The impact of early progression on the likelihood of survival to 90 days was examined with time-dependent Cox proportional hazards models. Results Mortality rates were 1.4% at 30 days, 3.4% at 60 days, and 5.5% at 90 days. Among baseline factors, advanced age, lower body mass index, poorer performance status, increased number of metastatic sites, BRAF mutant status, and several laboratory parameters were associated with increased likelihood of early mortality. A multivariable model for 90-day mortality showed strong internal discrimination (C-index, 0.77) and good calibration across risk groups as well as accurate predictions in the external validation set, both overall and within patient subgroups. Conclusion A validated clinical nomogram has been developed to quantify the risk of early death for individual patients during initial treatment of metastatic colorectal cancer. This tool may be used for patient eligibility assessment or risk stratification in future clinical trials and to identify patients requiring more or less aggressive therapy and additional supportive measures during and after treatment.

Published
2017

33. S3-Leitlinie Kolorektales Karzinom Version 1.0 - Juni 2013 AWMF-Registernummer: 021/007OL

Author

Axel Holstege, P. Lux, Anke Reinacher-Schick, J. Hübner, Nils Rahner, W. Hohenberger, Karsten Schulmann, Stefan Aretz, Stefan Post, A. Sieg, J. Ockenga, J. Riemann, Rolf Sauer, Ullrich Graeven, M. Hass, Andrea Tannapfel, P. Heußner, W. Schmiegel, Stephan C. Bischoff, M. Kreis, Frank T. Kolligs, Hans-Joachim Schmoll, W. Schmitt, Rainer Porschen, W. Scheppach, and Christian Pox

Subjects
Oncology, medicine.medical_specialty, Text mining, Colorectal cancer, business.industry, Internal medicine, Gastroenterology, medicine, MEDLINE, Guideline, medicine.disease, business
Published
2013

34. Body Mass Index Is Prognostic in Metastatic Colorectal Cancer: Pooled Analysis of Patients From First-Line Clinical Trials in the ARCAD Database

Author

Christophe Tournigand, Charles S. Fuchs, Eduardo Díaz-Rubio, Fotios Loupakis, Volker Heinemann, J. Randolph Hecht, Richard Adams, Benoist Chibaudel, Leonard B. Saltz, Herbert Hurwitz, Eric Van Cutsem, Cornelis J. A. Punt, Niall C. Tebbutt, Matthew T. Seymour, Heinz-Josef Lenz, Jean-Yves Douillard, Alfredo Falcone, Richard M. Goldberg, Daniel J. Sargent, Lindsay A. Renfro, Rainer Porschen, Aimery de Gramont, Hans-Joachim Schmoll, Carsten Bokemeyer, CCA -Cancer Center Amsterdam, and Oncology

Subjects
0301 basic medicine, Oncology, Male, Cancer Research, Cachexia, Databases, Factual, Colorectal cancer, Kaplan-Meier Estimate, Body Mass Index, 0302 clinical medicine, ADJUVANT CHEMOTHERAPY, Risk Factors, PROGRAM, Clinical Trials as Topic, COLON-CANCER, ORIGINAL REPORTS, Prognosis, 030220 oncology & carcinogenesis, Meta-analysis, Predictive value of tests, SURVIVAL, Female, Risk assessment, Colorectal Neoplasms, Signal Transduction, medicine.medical_specialty, Antineoplastic Agents, CACHEXIA, OBESITY, MORTALITY, WEIGHT, AGE, Risk Assessment, Disease-Free Survival, 03 medical and health sciences, Databases, Predictive Value of Tests, Internal medicine, medicine, Humans, Obesity, Factual, Selection Bias, business.industry, nutritional and metabolic diseases, medicine.disease, digestive system diseases, Clinical trial, 030104 developmental biology, business, Body mass index
Abstract

Purpose In recent retrospective analyses of early-stage colorectal cancer (CRC), low and high body mass index (BMI) scores were associated with worsened outcomes. Whether BMI is a prognostic or predictive factor in metastatic CRC (mCRC) is unclear. Patients and Methods Individual data from 21,149 patients enrolled onto 25 first-line mCRC trials during 1997 to 2012 were pooled. We assessed both prognostic and predictive effects of BMI on overall survival and progression-free survival, and we accounted for patient and tumor characteristics and therapy type (targeted v nontargeted). Results BMI was prognostic for overall survival (P < .001) and progression-free survival (P < .001), with an L-shaped pattern. That is, risk of progression and/or death was greatest for low BMI; risk decreased as BMI increased to approximately 28 kg/m2, and then it plateaued. Relative to obese patients, patients with a BMI of 18.5 kg/m2 had a 27% increased risk of having a PFS event (95% CI, 20% to 34%) and a 50% increased risk of death (95% CI, 43% to 56%). Low BMI was associated with poorer survival for men than women (interaction P < .001). BMI was not predictive of treatment effect. Conclusion Low BMI is associated with an increased risk of progression and death among the patients enrolled on the mCRC trials, with no increased risk for elevated BMI, in contrast to the adjuvant setting. Possible explanations include negative effects related to cancer cachexia in patients with low BMI, increased drug delivery or selection bias in patients with high BMI, and potential for an interaction between BMI and molecular signaling pathways.

Published
2016

35. Associations of incidence of common adverse events (AEs) and survival outcomes in metastatic colorectal cancer (mCRC) patients (pts) treated with first line chemotherapy: Findings from 9,812 pts in the ARCAD database

Author

Timothy J. Price, John Zalcberg, Volker Heinemann, Leonard B. Saltz, Eric Van Cutsem, Richard Adams, Danielle Ferraro, Carsten Bokemeyer, Aimery de Gramont, Charles S. Fuchs, Alfredo Falcone, Tim Maughan, Rainer Porschen, Matthew T. Seymour, Richard M. Goldberg, Eduardo Díaz-Rubio, Jeffrey P. Meyers, Herbert Hurwitz, Qian Shi, and Benoist Chibaudel

Subjects
Oncology, Cancer Research, medicine.medical_specialty, Colorectal cancer, business.industry, Incidence (epidemiology), medicine.disease, Cancer treatment, Internal medicine, medicine, First line chemotherapy, Adverse effect, business
Abstract

617 Background: There is limited, often conflicting evidence about AE timing, severity or associations with outcomes with the use of cytotoxic agents in cancer treatment. We investigated the impact on overall survival (OS) and progression-free survival (PFS) of selected common AEs (neutropenia, diarrhea, nausea, vomiting, neuropathy) occurring in patients receiving first line oxaliplatin (Oxa)- and/or irinotecan(Iri)-based regimens for mCRC. Methods: The CTCAE grading scores of at least one AE of interest were available on 9812 pts treated with chemotherapy alone (median age 63; 62.4% male, 50.1% ECOG PS 0) from 17 1st-line randomized trials. Patients who also received biologics were excluded in the primary analyses. AEs occurring during the first 6 weeks of treatment and entire treatment were analyzed by stratified multivariable Cox models in relationship to OS/PFS. 55.7% pts received Oxa- regimens, 35.7% Iri-regimens, and 8.6% combined Oxa- and Iri-regimens. Results: Within the first 6 weeks of treatment, G3+ neutropenia (HRadj= 1.3, 95% CI, 1.06-1.59, padj 0.01), diarrhea (HRadj= 1.48, 95% CI, 1.23-1.79, padj < .0001), nausea (HRadj= 1.53, 95% CI, 1.17-1.99, padj 0.002) and vomiting (HRadj= 1.56, 95% CI, 1.18-2.07, padj 0.002) were associated with significantly worse OS for Iri-regimens, but only G3+ nausea predicted for worse OS for Oxa- regimens (HRadj= 1.61, 95% CI, 1.18-2.21, padj 0.003). For AEs experienced at any time, G3+ neutropenia and neuropathy were significantly associated with longer PFS and OS for Oxa-regimens, while G3+ vomiting and nausea were associated with worse OS for both Oxa- and Iri-based regimens. Sensitivity analysis showed largely concordant results by including pts who also received biologics. Conclusions: The association between more severe selected AEs and outcome varies between AEs and is influenced by timing of the occurrence. More severe selected AEs occurring early in treatment are associated with worse outcomes. In contrast, for AEs occurring at any time, G3+ neutropenia and neuropathy predicted for longer PFS and/or OS in Oxa-treated pts.

Published
2018

36. S3 Guidelines for Colorectal Carcinoma

Author

Anke Reinacher-Schick, Werner Hohenberger, Jürgen F. Riemann, P. Frühmorgen, Ulrich R. Fölsch, Volker Heinemann, Gail K. Adler, Claus Rödel, Martin Zeitz, Dirk Arnold, Theodor Junginger, Wolfgang E. Fleig, H.-K. Selbmann, T. Kuhlbacher, P. Propping, Tilman Sauerbruch, I. Kopp, W. Schmitt, Hans-Joachim Schmoll, W. Schmiegel, Axel Holstege, Thomas Seufferlein, Rolf Sauer, Christian Pox, Rainer Porschen, and Ullrich Graeven

Subjects
Oncology, medicine.medical_specialty, business.industry, Colorectal cancer, Internal medicine, Gastroenterology, Medicine, business, medicine.disease
Published
2010

37. Gastrointestinale Onkologie – Therapieupdate 2008 / 2009

Author

Stefan Kubicka, Anke Reinacher-Schick, Rainer Porschen, Eckel F, Manfred P. Lutz, Bertram Wiedenmann, Tim F. Greten, Marianne Pavel, W. Schmiegel, Michael Geissler, Matthias P.A. Ebert, Markus Möhler, RM Schmid, Wolfgang Fischbach, Karel Caca, B. Göke, Thomas Seufferlein, Opitz O, and Christoph J. Auernhammer

Subjects
Oncology, medicine.medical_specialty, Colorectal cancer, business.industry, Steering committee, Gastroenterology, medicine.disease, Tumour therapy, Internal medicine, medicine, Combined Modality Therapy, Treatment strategy, Neoplasm staging, business, Stomach cancer, Predictive biomarker
Abstract

As a consequence of recent studies the treatment of gastrointestinal cancers has become challenging and is undergoing constant changes on the basis of the results of new trials. The steering committee of the working group on gastrointestinal cancers of the Deutsche Gesellschaft fur Verdauungs- und Stoffwechselkrankheiten has decided to summarise and present recent updates of the current treatment guidelines and recommendations for the most relevant gastrointestinal malignancies. In this review we have included recent findings from large trials on esophageal, gastric, pancreatic, cholangiocellular and liver cancers, as well as colorectal cancers, neuroendocrine tumours and lymphomas. This includes an update on the combination with novel targeted agents and the introduction of potential predictive biomarkers in the selection of the appropriate treatment strategy.

Published
2009

38. S3-Leitlinie 'Kolorektales Karzinom' – Aktualisierung 2008

Author

Christian Pox, Hans-Joachim Schmoll, W. Schmitt, Ullrich Graeven, Volker Heinemann, Rainer Porschen, Thomas Seufferlein, Dirk Arnold, Wolff Schmiegel, Anke Reinacher-Schick, I. Kopp, J. Riemann, M. Wieser, Claus Rödel, and Rolf Sauer

Subjects
medicine.medical_specialty, medicine.diagnostic_test, business.industry, Colorectal cancer, General surgery, Gastroenterology, MEDLINE, Salvage therapy, Sigmoidoscopy, Evidence-based medicine, Guideline, medicine.disease, Text mining, Medicine, Combined Modality Therapy, business
Published
2008

39. Diagnostik beim Magenkarzinom

Author

Rainer Porschen, Michael Hünerbein, and Ch. Englisch-Fritz

Subjects
Gynecology, medicine.medical_specialty, Oncology, business.industry, Medicine, Hematology, business
Abstract

Bei Patienten mit Magenkarzinom ist ein interdisziplinarer Ansatz wichtig fur die Entscheidung, welche Therapie gewahlt werden soll. Die klinische Symptomatik ist oft unspezifisch. Das haufigste Metastasierungsorgan ist die Leber. Bei den Laboruntersuchungen spielen Tumormarker eine eher untergeordnete Rolle. Neben den optischen Verfahren der Endoskopie hat der endoskopische Ultraschall (EUS) inzwischen einen festen Stellenwert fur die Diagnostik und das Staging des Magenkarzinoms. Beim Staging und zur praoperativen Beurteilung des Magenkarzinoms werden zur Endosonographie erganzende bildgebende Verfahren eingesetzt. Eine viel versprechende Weiterentwicklung, aber noch keine Standarddiagnostik ist die Positronenemissionstomographie (PET). Die Laparoskopie ermoglicht eine genauere Aussage uber den Lymphknotenbefall des Kompartiments II und nach Eroffnung der Bursa omentalis bei lokal fortgeschrittenen Tumoren die direkte Uberprufung einer Infiltration von Pankreas bzw. linkem Leberlappen.

Published
2008

40. Oxaliplatin in Combination with 5-Fluorouracil/Leucovorin or Capecitabine in Elderly Patients with Metastatic Colorectal Cancer

Author

Hans-Joachim Schmoll, S. Kubicka, Christina Englisch-Fritz, Hendrik Tobias Arkenau, Richard Greil, Wolff Schmiegel, Axel Hinke, Ullrich Graeven, Albrecht Kretzschmar, Axel Grothey, Rainer Porschen, Thomas Seufferlein, and W. Freier

Subjects
Oncology, medicine.medical_specialty, Organoplatinum Compounds, Colorectal cancer, Population, Leucovorin, Kaplan-Meier Estimate, Deoxycytidine, Capecitabine, FOLFOX, Internal medicine, Antineoplastic Combined Chemotherapy Protocols, medicine, Humans, Neoplasm Metastasis, education, Survival rate, Aged, education.field_of_study, business.industry, Age Factors, Gastroenterology, medicine.disease, Oxaliplatin, Survival Rate, Irinotecan, Fluorouracil, Colorectal Neoplasms, business, medicine.drug
Abstract

We evaluated the outcome of 140 patients agedor = 70 years of age who received first-line treatment for metastatic colorectal cancer within the German phase III trial of FUFOX (5-fluorouracil/leucovorin/oxaliplatin) versus CAPOX (capecitabine/oxaliplatin).One hundred forty (30%) elderly patients of 476 total patients were identified, and 138 patients received the CAPOX or FUFOX treatment.Overall, treatment was well tolerated, and grade 3/4 toxicities were similar in both groups, with more gastrointestinal side effects in the elderly group but less neurosensory side effects. The response rate (RR) was comparable between both cohorts (49% in elderly patients vs. 52% in patients aged70 years). Median progression-free survival (PFS) was 7.7 months for patients agedor = 70 years and 7.5 months for patients aged70 years (hazard ratio [HR], 1.07; 95% CI, 0.86-1.34). With regard to the chemotherapy regimen, there was no inferiority between FUFOX and CAPOX in patients agedor = 70 years (7.9 months vs. 7.6 months). The median overall survival (OS) between FUFOX and CAPOX was comparable in patients agedor = 70 years (14.4 months vs. 14.2 months). However, when compared with patients aged70 years, the median OS was significantly shorter (18.8 months vs. 14.4 months; P = 0.013; HR, 1.37; 95% CI, 1.07-1.76). This was consistent with our multivariate analysis, which revealed that ageor = 70 years was a negative factor for OS.Oxaliplatin combined with 5-FU/leucovorin or capecitabine was generally well tolerated in elderly patients. Elderly patients had similar PFS and overall RRs compared with the population aged70 years, but the OS was shorter.

Published
2008

41. Phase III Study of Capecitabine Plus Oxaliplatin Compared With Fluorouracil and Leucovorin Plus Oxaliplatin in Metastatic Colorectal Cancer: A Final Report of the AIO Colorectal Study Group

Author

Thomas Seufferlein, Richard Greil, Ullrich Graeven, S. Kubicka, Albrecht Kretzschmar, Rainer Porschen, Axel Grothey, Hans Joachim Schmoll, Axel Hinke, Hendrik Tobias Arkenau, Wolff Schmiegel, and W. Freier

Subjects
Cancer Research, medicine.medical_specialty, business.industry, Colorectal cancer, CAPOX Regimen, medicine.disease, Gastroenterology, Surgery, Oxaliplatin, Irinotecan, Capecitabine, Folinic acid, chemistry.chemical_compound, Oncology, chemistry, Fluorouracil, Internal medicine, medicine, Deoxycytidine, business, medicine.drug
Abstract

Purpose To compare the use of capecitabine plus oxaliplatin (CAPOX) with infusional fluorouracil (FU)/folinic acid plus oxaliplatin (FUFOX) as first-line therapy for patients with metastatic colorectal cancer (MCRC). Patients and Methods A total of 474 patients with MCRC received either CAPOX (capecitabine 1,000 mg/m2 bid, days 1 to 14 plus oxaliplatin 70 mg/m2 days 1 and 8, repeated every 22 days) ) or FUFOX (oxaliplatin 50 mg/m2 followed by leucovorin 500 mg/m2 plus FU 2,000 mg/m2 as a 22-hour infusion days 1, 8, 15, and 22, repeated every 36 days). The primary end point was progression-free survival (PFS). Secondary end points were response rate (RR), overall survival (OS), time to treatment failure, and toxicity. The study was designed to determine noninferiority for the CAPOX regimen. Results Median PFS was 7.1 months in the CAPOX arm and 8.0 months in the FUFOX arm (hazard ratio [HR], 1.17; 95% CI, 0.96 to 1.43; P = .117). Median OS was 16.8 months (CAPOX) and 18.8 months (FUFOX; HR, 1.12; 95% CI, 0.92 to 1.38; P = .26). Overall RRs were 48% for CAPOX (95% CI, 41% to 54%) and 54% for FUFOX (95% CI, 47% to 60%). Both regimens were generally well tolerated, although there was a significantly higher incidence of grade 2/3 hand-foot syndrome (HFS) in the CAPOX arm (P = .028). Conclusion CAPOX resulted in a slightly inferior efficacy than FUFOX. With respect to PFS, the best estimate of the HR of 1.17 was within the prespecified equivalence range. However, a relevant inferiority cannot be excluded. Both regimens were generally well tolerated but there was a significantly higher rate of grade 2/3 HFS in the CAPOX arm.

Published
2007

42. Studies on p53, BAX and Bcl-2 protein expression and microsatellite instability in stage III (UICC) colon cancer treated by adjuvant chemotherapy: major prognostic impact of proapoptotic BAX

Author

B. Klump, Vera Gaco, Thomas Okech, Rainer Porschen, Borchard F, Hans-Helmut Gruenagel, Chih-Jen Hsieh, O. Nehls, H. T. Arkenau, T. Enzinger, Joerg T. Hartmann, Holger G. Hass, Michael Gregor, and Mario Sarbia

Subjects
Male, Oncology, Cancer Research, medicine.medical_specialty, Pathology, Colorectal cancer, medicine.medical_treatment, Apoptosis, colon carcinoma, Folinic acid, Bcl-2-associated X protein, Internal medicine, medicine, Carcinoma, Humans, Bcl-2, Molecular Diagnostics, Aged, Neoplasm Staging, bcl-2-Associated X Protein, Chemotherapy, biology, Microsatellite instability, Middle Aged, Prognosis, medicine.disease, adjuvant chemotherapy, Proto-Oncogene Proteins c-bcl-2, Chemotherapy, Adjuvant, BAX, Fluorouracil, p53/BAX pathway, Colonic Neoplasms, biology.protein, Immunohistochemistry, Female, microsatellite instability, Tumor Suppressor Protein p53, Follow-Up Studies, BAT26, medicine.drug
Abstract

We evaluated the expression patterns of proapoptotic BAX, antiapoptotic Bcl-2 and p53, the proposed upstream effector of these molecules, as potential prognostic markers in UICC stage III colon cancer by immunohistochemical staining. To identify high-frequency microsatellite instability (MSI+) individuals, we performed single-strand conformation polymorphism-based analysis for BAT26. A total of 188 patients who had received 5-fluorouracil (5-FU)-based adjuvant chemotherapy (5-FU/folinic acid or 5-FU/levamisole) were enrolled. Median follow-up was 84.5 months. We found that BAX, Bcl-2 and p53 protein expressions were high or positive in 59, 70 and 50% of 188 cases, respectively. MSI+ tumours were detected in 9% of 174 evaluable patients. BAX or Bcl-2 was correlated with a higher degree of differentiation or left-sided tumours (P=0.01 or P=0.03, respectively); MSI was correlated with right-sided tumours (P

Published
2007

43. 5-Fluorouracil/folinic acid plus oxaliplatin (FUFOX, arm A) versus capecitabine plus oxaliplatin (CAPOX, arm B) in the treatment of advanced colorectal carcinoma (ACRC)

Author

Hendrik-Tobias Arkenau, Peter Reichardt, A. Grothey, Gail K. Adler, B Petershagen, Axel Hinke, Ullrich Graeven, Rainer Porschen, H.-J. Schmoll, and W. Schmiegel

Subjects
medicine.medical_specialty, Colorectal cancer, business.industry, Gastroenterology, medicine.disease, Oxaliplatin, Capecitabine, Folinic acid, Fluorouracil, Internal medicine, medicine, business, medicine.drug
Published
2015

44. Prognostic value of microsatellite instability and p53 expression in metastatic colorectal cancer treated with oxaliplatin and fluoropyrimidine-based chemotherapy

Author

Andrea Tannapfel, Ullrich Graeven, Rainer Porschen, W. Schmiegel, Karsten Schulmann, Stefanie Nöpel-Dünnebacke, and Anke Reinacher-Schick

Subjects
Oncology, Adult, Male, medicine.medical_specialty, Organoplatinum Compounds, Colorectal cancer, medicine.medical_treatment, Sensitivity and Specificity, Internal medicine, Antineoplastic Combined Chemotherapy Protocols, medicine, Biomarkers, Tumor, Humans, neoplasms, Aged, Aged, 80 and over, Chemotherapy, Cetuximab, business.industry, Carcinoma, Gastroenterology, Microsatellite instability, Reproducibility of Results, Middle Aged, medicine.disease, Prognosis, digestive system diseases, Oxaliplatin, Clinical trial, Irinotecan, Treatment Outcome, Immunohistochemistry, Female, Microsatellite Instability, Fluorouracil, Tumor Suppressor Protein p53, business, Colorectal Neoplasms, Biomarkers, medicine.drug, Microsatellite Repeats
Abstract

Purpose: The aim of this study was to evaluate the prognostic value of MSI-H and p53 overexpression in metastatic colorectal cancer (mCRC) treated with oxaliplatin and fluoropyrimidine-based first line chemotherapy. Methods: Tumour samples were retrospectively obtained from 229 patients from a prospective randomised phase III trial of the AIO colorectal study group, comparing CAPOX and FUFOX in mCRC. Immunohistochemistry of p53 and MMR proteins as well as microsatellite analysis were performed. Results: The incidence of MSI-H and p53 overexpression was 7.9 % and 65.4 %, respectively. MSI-H status was not correlated with ORR, PFS and OS. We observed a trend to lower DCR for MSI-H tumours (65 % vs. 85 %, p = 0.055). p53 overexpression was not correlated with DCR, ORR and PFS. The median OS of patients with tumors with p53 overexpression was significantly longer compared to tumors withhout p53 overexpression (19.6 vs. 15.8 months; p = 0.05). The post-progression survival (PPS) of p53-positive patients undergoing 2nd and/or 3rd line chemotherapy with irinotecan and/or cetuximab was significantly longer compared to p53-negative patients. Conclusion: MSI-H tumours tend to have lower disease control rates when treated with an oxaliplatin/fluoropyrmidin combination. mCRC patients with p53 overexpression undergoing an irinotecan containing second- or third-line chemotherapy after oxaliplatin failure have a significantly longer post-progression survival compared to patients without p53 overexpression. To validate the clinical impact of p53 in patients with mCRC treated with irinotecan- and/or cetuximab further studies are needed.

Published
2014

45. Themenkomplex VI: Barrett-Ösophagus

Author

Christian Ell, Helmut Messmann, Rainer Porschen, Manfred Stolte, Ralf Kiesslich, M. Ortner, and Martin Fein

Subjects
business.industry, Gastroenterology, Library science, Medicine, business
Published
2005

46. Low bax protein expression correlates with disease recurrence in preoperatively irradiated rectal carcinoma

Author

Vera Gaco, Chih-Jen Hsieh, Michael Gregor, Mario Sarbia, Thomas Okech, O. Nehls, Rainer Porschen, Bodo Klump, Hans-Helmut Gruenagel, and Franz Borchard

Subjects
Adult, Male, Cancer Research, medicine.medical_specialty, Pathology, Multivariate analysis, Statistics as Topic, Apoptosis, Subgroup analysis, Disease, Adenocarcinoma, Gastroenterology, Text mining, Internal medicine, Biopsy, medicine, Humans, Radiology, Nuclear Medicine and imaging, Aged, bcl-2-Associated X Protein, Aged, 80 and over, Univariate analysis, Radiation, medicine.diagnostic_test, Rectal Neoplasms, business.industry, Middle Aged, Prognosis, Proto-Oncogene Proteins c-bcl-2, Oncology, Immunohistochemistry, Female, Neoplasm Recurrence, Local, Tumor Suppressor Protein p53, business
Abstract

Purpose To determine the prognostic impact of BAX in correlation to its upstream effector p53 as well as clinicopathologic variables and patient outcome in preoperatively irradiated rectal carcinoma. Methods and materials We investigated 92 rectal carcinoma patients treated by preoperative radiotherapy to a total dose of 30 Gy followed by surgery. Median follow-up was 71 months. Immunohistochemistry was performed on paraffin sections of pretreatment biopsy samples for BAX protein. Also, we considered the previously determined p53 expression data from this cohort. Results BAX protein expression was classified as high and low in 63 (68.5%) and 29 (31.5%) tumors, respectively. Unlike clinicopathologic variables, high BAX expression was significantly associated with improved disease-free survival by univariate analysis ( p = 0.048). Moreover, in multivariate analyses, high BAX expression was an independent prognostic indicator for both improved local recurrence–free interval and improved disease-free survival ( p = 0.03 and 0.047, respectively). Concerning the p53/BAX pathway, subgroup analysis yielded no association between p53 immunonegative/BAX high vs. p53 immunopositive/BAX low expressing tumors with regard to overall, disease-free, or local recurrence–free survival in either univariate ( p = 0.88, 0.54, and 0.16, respectively) or multivariate analysis. Conclusions This study demonstrates that BAX protein expression might help to predict disease recurrence in preoperatively irradiated rectal carcinoma, whereas determination of p53, the proposed upstream regulator of BAX-induced apoptosis, did not provide additional prognostic information.

Published
2005

47. S3-Guidelines Colorectal Cancer 2004

Author

W. Schmiegel, Hans-Joachim Schmoll, Wolfgang E. Fleig, Ullrich Graeven, Rainer Porschen, J. Riemann, Ulrich R. Fölsch, P. Frühmorgen, T. Kuhlbacher, P. Propping, T Junginger, Christian Pox, Gail K. Adler, H.-K. Selbmann, Deutschen Gesellschaft für Verdauungs, Martin Zeitz, Axel Holstege, Werner Hohenberger, Rolf Sauer, and Tilman Sauerbruch

Subjects
medicine.medical_specialty, Colorectal cancer, Practice patterns, business.industry, General surgery, Gastroenterology, medicine, MEDLINE, Guideline, medicine.disease, business
Published
2004

48. Molecular lesions in colorectal cancer: impact on prognosis?

Author

Franz Borchard, A. Greschniok, O. Nehls, Michael Gregor, Thomas Okech, Rainer Porschen, Bodo Klump, Hans-Helmut Gruenagel, Vera Gaco, Mario Sarbia, Chih-Jen Hsieh, and F. S. Gittinger

Subjects
medicine.medical_specialty, Chemotherapy, business.industry, Colorectal cancer, medicine.medical_treatment, Gastroenterology, Disease, Hepatology, medicine.disease, humanities, Colon carcinoma, Internal medicine, medicine, In patient, business, Rectal disease, Colonic disease
Abstract

Background In the Dukes' B and C stages of colorectal carcinoma there are considerable variations in the observed courses of the disease. Since post-operative chemotherapy in patients with Dukes' C (node-positive) colon carcinoma has been demonstrated to be effective in improving overall-survival, a more exact prognosis assessment gains additional significance and therapeutic relevance.

Published
2004

49. Chemotherapie nach Pankreaskarzinomresektion

Author

Rainer Porschen

Subjects
03 medical and health sciences, 0302 clinical medicine, business.industry, 030220 oncology & carcinogenesis, Medicine, 030212 general & internal medicine, business
Published
2016

50. Methylation status of p14ARF and p16INK4a as detected in pancreatic secretions

Author

R Kießlich, B. Klump, U Sinn, S. Dette, Chih-Jen Hsieh, O. Nehls, Rainer Porschen, K Holzmann, M Jung, M Ortner, and Michael Gregor

Subjects
Adult, Cancer Research, Pathology, medicine.medical_specialty, Pancreatic disease, Tumor suppressor gene, pancreatitis, p16, Adenocarcinoma, Biology, medicine.disease_cause, Polymerase Chain Reaction, p14, p14arf, Tumor Suppressor Protein p14ARF, medicine, Bile, Humans, Promoter Regions, Genetic, Pancreas, Cyclin-Dependent Kinase Inhibitor p16, Aged, DNA Primers, Aged, 80 and over, Cholangiopancreatography, Endoscopic Retrograde, pancreatic carcinoma, Molecular and Cellular Pathology, DNA, Neoplasm, Methylation, DNA Methylation, Middle Aged, medicine.disease, Gene Expression Regulation, Neoplastic, Pancreatic Neoplasms, medicine.anatomical_structure, Oncology, Case-Control Studies, Chronic Disease, Mutation, DNA methylation, Cancer research, Pancreatitis, methylation, Carcinogenesis
Abstract

The clinical management of pancreatic disease is often hampered by a lack of tissue diagnosis. Endoscopic pancreatography offers the opportunity to investigate exfoliated cells. However, the significance of mere cytological investigation is compromised by an insufficient sensitivity. The evaluation of the molecular background of carcinogenesis hopefully is capable of providing more sensitive diagnostic markers. The p16INK4a-/retinoblastoma tumour-suppressive pathway has been shown to be involved in the development of near to all pancreatic neoplasms. p14ARF is another tumour suppressor located in the immediate neighbourhood of p16INK4a. Promoter methylation has been demonstrated to be a major inactivating mechanism of both genes. We sought to further evaluate the role of the gene locus INK4a methylation status in the endoscopic differentiation of chronic inflammatory and neoplastic pancreatic disease. Pancreatic fluid specimens of 61 patients with either pancreatic carcinoma (PCA: 39), chronic pancreatitis (CP: 16) or a normal pancreatogram (NAD: 6) were retrieved. In order to detect methylation of either the p14ARF or the p16INK4a promoter a methylation-specific PCR protocol was applied. While 19 out of 39 patients with PCA showed p16 promoter methylation (49%), none of the 16 patients with CP revealed p16 promoter methylation. p14ARF methylation was found in a lower percentage of PCA specimens and in none of the samples of patients with CP. These results suggest a specific significance of INK4a for the development of malignant pancreatic disease. Our data further indicate a potential role for INK4a methylation as a diagnostic marker in the endoscopic differentiation of benign and malignant pancreatic disease.

Published
2003

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