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Werkl P, Sommer M, Singer C, Tomasic H, Seidel G, Woltsche N. [Central retinal vein thrombosis in a 21-year-old man-What is the cause?]. Ophthalmologie 2023; 120:838-840. [PMID: 35947155 PMCID: PMC9364846 DOI: 10.1007/s00347-022-01703-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 07/09/2022] [Accepted: 07/15/2022] [Indexed: 12/01/2022]
Affiliation(s)
- P Werkl
- Universitätsaugenklinik Graz, Medizinische Universität Graz, Auenbruggerplatz 4, 8036, Graz, Österreich.
| | - M Sommer
- Universitätsaugenklinik Graz, Medizinische Universität Graz, Auenbruggerplatz 4, 8036, Graz, Österreich
| | - C Singer
- Universitätsaugenklinik Graz, Medizinische Universität Graz, Auenbruggerplatz 4, 8036, Graz, Österreich
| | - H Tomasic
- Universitätsaugenklinik Graz, Medizinische Universität Graz, Auenbruggerplatz 4, 8036, Graz, Österreich
| | - G Seidel
- Universitätsaugenklinik Graz, Medizinische Universität Graz, Auenbruggerplatz 4, 8036, Graz, Österreich
| | - N Woltsche
- Universitätsaugenklinik Graz, Medizinische Universität Graz, Auenbruggerplatz 4, 8036, Graz, Österreich
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Singer C. SA 4.3 Management of patients harboring medium penetrance genes. Breast 2023. [DOI: 10.1016/s0960-9776(23)00085-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023] Open
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Gampenrieder SP, Dezentjé V, Lambertini M, de Nonneville A, Marhold M, Le Du F, Cortés Salgado A, Alpuim Costa D, Vaz Batista M, Chic Ruché N, Tinchon C, Petzer A, Blondeaux E, Del Mastro L, Targato G, Bertucci F, Gonçalves A, Viret F, Bartsch R, Mannsbart C, Deleuze A, Robert L, Saavedra Serrano C, Gion Cortés M, Sampaio-Alves M, Vitorino M, Pecen L, Singer C, Harbeck N, Rinnerthaler G, Greil R. Influence of HER2 expression on prognosis in metastatic triple-negative breast cancer-results from an international, multicenter analysis coordinated by the AGMT Study Group. ESMO Open 2023; 8:100747. [PMID: 36563519 PMCID: PMC10024122 DOI: 10.1016/j.esmoop.2022.100747] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 11/16/2022] [Accepted: 11/22/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Triple-negative breast cancer (TNBC) is associated with poor prognosis, and new treatment options are urgently needed. About 34%-39% of primary TNBCs show a low expression of human epidermal growth factor receptor 2 (HER2-low), which is a target for new anti-HER2 drugs. However, little is known about the frequency and the prognostic value of HER2-low in metastatic TNBC. PATIENTS AND METHODS We retrospectively included patients with TNBC from five European countries for this international, multicenter analysis. Triple-negativity had to be shown in a metastatic site or in the primary breast tumor diagnosed simultaneously or within 3 years before metastatic disease. HER2-low was defined as immunohistochemically (IHC) 1+ or 2+ without ERBB2 gene amplification. Survival probabilities were calculated by the Kaplan-Meier method, and multivariable hazard ratios (HRs) were estimated by Cox regression models. RESULTS In total, 691 patients, diagnosed between January 2006 and February 2021, were assessable. The incidence of HER2-low was 32.0% [95% confidence interval (CI) 28.5% to 35.5%], with similar proportions in metastases (n = 265; 29.8%) and primary tumors (n = 425; 33.4%; P = 0.324). The median overall survival (OS) in HER2-low and HER2-0 TNBC was 18.6 and 16.1 months, respectively (HR 1.00; 95% CI 0.83-1.19; P = 0.969). Similarly, in multivariable analysis, HER2-low had no significant impact on OS (HR 0.95; 95% CI 0.79-1.13; P = 0.545). No difference in prognosis was observed between HER2 IHC 0/1+ and IHC 2+ tumors (HR 0.89; 95% CI 0.69-1.17; P = 0.414). CONCLUSIONS In this large international dataset of metastatic TNBC, the frequency of HER2-low was 32.0%. Neither in univariable nor in multivariable analysis HER2-low showed any influence on OS.
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Affiliation(s)
- S P Gampenrieder
- Salzburg Cancer Research Institute- Center for Clinical Cancer and Immunology Trials, Salzburg, Austria; Cancer Cluster Salzburg, Salzburg, Austria; IIIrd Medical Department with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Oncologic Center, Paracelsus Medical University Salzburg, Salzburg, Austria
| | - V Dezentjé
- Department of Medical Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - M Lambertini
- Medical Oncology Department, U.O.C. Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino Genova, Genova, Italy; Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, Università di Genova, Genova, Italy
| | - A de Nonneville
- Department of Medical Oncology, Institut Paoli-Calmettes, Aix-Marseille Univ, CNRS, INSERM, Marseille, France
| | - M Marhold
- Department of Medicine I, Division of Oncology, Medical University of Vienna, Vienna, Austria
| | - F Le Du
- Département d'oncologie médicale, Centre Eugène-Marquis, Rennes, France
| | - A Cortés Salgado
- Medical Oncology Department, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - D Alpuim Costa
- Haematology and Oncology Department, CUF Oncologia, Lisbon, Portugal; NOVA Medical School, (NMS), Faculdade de Ciências Médicas (FCM), Lisbon, Portugal; Centro de Medicina Subaquática e Hiperbárica (CMSH), Marinha Portuguesa, Lisbon, Portugal
| | - M Vaz Batista
- Oncology Department, Hospital Professor Doutor Fernando Fonseca, Amadora, Portugal
| | - N Chic Ruché
- Department of Medical Oncology, Hospital Clínic Barcelona, Barcelona, Spain
| | - C Tinchon
- Department for Haemato-Oncology, LKH Hochsteiermark-Leoben, Leoben, Austria
| | - A Petzer
- Internal Medicine I for Hematology with Stem Cell Transplantation, Hemostaseology and Medical Oncology, Ordensklinikum Linz Barmherzige Schwestern-Elisabethinen, Linz, Austria
| | - E Blondeaux
- U.O. Epidemiology Unit, IRCCS Ospedale Policlinico San Martino Genova, Genova, Italy
| | - L Del Mastro
- Medical Oncology Department, U.O.C. Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino Genova, Genova, Italy; Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, Università di Genova, Genova, Italy
| | - G Targato
- Dipartimento di Oncologia, Ospedale Santa Maria della Misericordia di Udine, Udine, Italy
| | - F Bertucci
- Department of Medical Oncology, Institut Paoli-Calmettes, Aix-Marseille Univ, CNRS, INSERM, Marseille, France
| | - A Gonçalves
- Department of Medical Oncology, Institut Paoli-Calmettes, Aix-Marseille Univ, CNRS, INSERM, Marseille, France
| | - F Viret
- Department of Medical Oncology, Institut Paoli-Calmettes, Aix-Marseille Univ, CNRS, INSERM, Marseille, France
| | - R Bartsch
- Department of Medicine I, Division of Oncology, Medical University of Vienna, Vienna, Austria
| | - C Mannsbart
- Department of Medicine I, Division of Oncology, Medical University of Vienna, Vienna, Austria
| | - A Deleuze
- Département d'oncologie médicale, Centre Eugène-Marquis, Rennes, France
| | - L Robert
- Département d'oncologie médicale, Centre Eugène-Marquis, Rennes, France
| | - C Saavedra Serrano
- Medical Oncology Department, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - M Gion Cortés
- Medical Oncology Department, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - M Sampaio-Alves
- Faculdade de Medicina, Universidade do Porto (FMUP), Oporto, Portugal
| | - M Vitorino
- Oncology Department, Hospital Professor Doutor Fernando Fonseca, Amadora, Portugal
| | - L Pecen
- Institute of Computer Science, Czech Academy of Sciences, Praha, Czech Republic; Faculty of Medicine in Pilsen - Charles University, Pilsen, Czech Republic
| | - C Singer
- Department of Obstetrics and Gynecology and Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - N Harbeck
- Breast Center, Department of Gynecology and Obstetrics, Comprehensive Cancer Center of the Ludwig-Maximilians-University, Munich, Germany
| | - G Rinnerthaler
- Salzburg Cancer Research Institute- Center for Clinical Cancer and Immunology Trials, Salzburg, Austria; Cancer Cluster Salzburg, Salzburg, Austria; IIIrd Medical Department with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Oncologic Center, Paracelsus Medical University Salzburg, Salzburg, Austria
| | - R Greil
- Salzburg Cancer Research Institute- Center for Clinical Cancer and Immunology Trials, Salzburg, Austria; Cancer Cluster Salzburg, Salzburg, Austria; IIIrd Medical Department with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Oncologic Center, Paracelsus Medical University Salzburg, Salzburg, Austria.
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Kleiner Shochat M, Mohsen J, Abu Rumi M, Hellou E, Abolil M, Singer C, Kazatsker M, Kobo O, Roguin A, Meisel S. Monitoring of the lung fluid status in hospitalized COVID-19 patients for predicts outcome. Results of the IMPEDANCE-Corona Trial. Eur Heart J 2022. [PMCID: PMC9619567 DOI: 10.1093/eurheartj/ehac544.1066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Introduction Prediction of the clinical deterioration in hospitalized COVOD-19 patients is an unmet goal. Aim To assess monitoring of lung fluid status of hospitalized COVID-19 patients as a tool to predict clinical respiratory deterioration and prognosis. Methods The present study population comprised 51 patients hospitalized in our medical center with COVID-19 infection. The lung fluid status of patients was monitored by repeat measurements the lung impedance (LI). The LI technique was found to be a very effective tool for monitoring and guiding the treatment of a heart failure patients. Decreasing LI reflects lung fluid accumulation. Clinical and laboratory parameters, chest X-ray (CXR) and LI level were recorded during hospitalization. Results Of the 51 patients hospitalized for COVID-19 infection (37 men and 14 women, 55.7±12.6 years old), 46 were discharged after successful treatment (Group 1) and 5 (9.8%) died during hospitalization (Group 2). The LI kinetics during hospitalization demonstrated a different pattern between groups (Figure 1, p<0.01). In group 1 patients, a small LI decrease (−3.5±4.3%, p=0.7) during the first 4 days (median = 2.2 days, [Q1–3: 1–3.7 days]) of hospitalization was noted. Following this, LI increased progressively until discharge (+20.3±12.3%, p<0.01). Among group 2 patients, LI decreased progressively during hospitalization. Mechanical ventilation was initiated at the eighth day [median = 8, Q1–3: 4–12 days] when LI decreased by 18.2±3.8% in comparison with the admission level (p<0.01). Deaths occurred at 12.4±2.7 days (median = 12 days) after admission. Multivariate Cox regression analysis of clinical, laboratory and CXR variance has shown that the degree of LI decrease during hospitalization is the most reliable predictor of death (hazard ratio: 1.36 [1.04–1.79], p<0.04). Conclusions The combination of progressively decreasing LI after 4 days of hospitalization for COVID-19 infection and an LI decrease >15% is the most reliable predictor of death. Funding Acknowledgement Type of funding sources: None.
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Affiliation(s)
| | - J Mohsen
- Hillel Yaffe Medical Center, Heart Institute , Hadera , Israel
| | - M Abu Rumi
- Hillel Yaffe Medical Center, Heart Institute , Hadera , Israel
| | - E Hellou
- Hillel Yaffe Medical Center, Heart Institute , Hadera , Israel
| | - M Abolil
- Hillel Yaffe Medical Center, Heart Institute , Hadera , Israel
| | - C Singer
- Hillel Yaffe Medical Center, Heart Institute , Hadera , Israel
| | - M Kazatsker
- Hillel Yaffe Medical Center, Heart Institute , Hadera , Israel
| | - O Kobo
- Hillel Yaffe Medical Center, Heart Institute , Hadera , Israel
| | - A Roguin
- Hillel Yaffe Medical Center, Heart Institute , Hadera , Israel
| | - S Meisel
- Hillel Yaffe Medical Center, Heart Institute , Hadera , Israel
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Starzer A, Berghoff A, Furtner J, Marhold M, Bergen E, Roider-Schur S, Forstner H, Rottenmanner B, Dieckmann K, Bago-Horvath Z, Widhalm G, Ilhan-Mutlu A, Minichsdorfer C, Fuereder T, Gruenberger B, Singer C, Weltermann A, R. Puhr, Preusser M, Bartsch R. 281MO Quality of life and neurocognitive function in patients with active brain metastases of HER2-positive breast cancer treated with trastuzumab-deruxtecan: Secondary endpoint analysis of the prospective single-arm phase II TUXEDO-1 trial. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Steindl A, Schweighart K, Zach C, Grisold A, Gatterbauer B, Dieckmann K, Bago-Horvath Z, Exner R, Fitzal F, Pfeiler G, Singer C, Widhalm G, Bartsch R, Preusser M, Berghoff A. 307P Incidence of neurological symptoms in brain metastases from breast cancer and its impact on prognosis: An analysis of 968 patients with brain metastases. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Tutt A, Garber J, Gelber R, Phillips KA, Eisen A, Johannsson O, Rastogi P, Cui K, Im SA, Yerushalmi R, Brufsky A, Taboada M, Rossi G, Yothers G, Singer C, Fein L, Loman N, Cameron D, Campbell C, Geyer C. VP1-2022: Pre-specified event driven analysis of Overall Survival (OS) in the OlympiA phase III trial of adjuvant olaparib (OL) in germline BRCA1/2 mutation (gBRCAm) associated breast cancer. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.03.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Nicholas A, Singer C, Robottom B, Bhargava P, Navia B. Impact of baseline factors on response to apomorphine sublingual film in patients with Parkinson's disease and “OFF” episodes. Parkinsonism Relat Disord 2020. [DOI: 10.1016/j.parkreldis.2020.06.310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Chepke C, Marder S, Comella C, Singer C, Farahmand K, Shah C, Lundt L. Long-term treatment with valbenazine 40 mg once-daily in adults with Tardive dyskinesia. Parkinsonism Relat Disord 2020. [DOI: 10.1016/j.parkreldis.2020.06.433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Danzinger S, Hielscher N, Metzler J, Izsó M, Trinkl C, Singer C. Invasiv lobuläres Mammakarzinom und seine Charakteristik – Auswertung eines Tumorregisters. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1713231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Affiliation(s)
- S Danzinger
- Universitätsklinik für Frauenheilkunde, Mediznische Universität Wien
| | - N Hielscher
- Universitätsklinik für Frauenheilkunde, Mediznische Universität Wien
| | - J Metzler
- Universitätsklinik für Frauenheilkunde, Mediznische Universität Wien
| | - M Izsó
- Universitätsklinik für Frauenheilkunde, Mediznische Universität Wien
| | - C Trinkl
- Universitätsklinik für Frauenheilkunde, Mediznische Universität Wien
| | - C Singer
- Universitätsklinik für Frauenheilkunde, Mediznische Universität Wien
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Danzinger S, Seifert M, Singer C. Inzidenz steigend und herausfordernd: Onkologie & 90 +. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1713232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Affiliation(s)
- S Danzinger
- Universitätsklinik für Frauenheilkunde, Mediznische Universität Wien
| | - M Seifert
- Universitätsklinik für Frauenheilkunde, Mediznische Universität Wien
| | - C Singer
- Universitätsklinik für Frauenheilkunde, Mediznische Universität Wien
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12
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Danzinger S, Hielscher N, Metzler J, Izsó M, Trinkl C, Singer C. Primäre invasive Mammakarzinome: eine Auswertung der Tumordatenbank. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1713233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Affiliation(s)
- S Danzinger
- Universitätsklinik für Frauenheilkunde, Mediznische Universität Wien
| | - N Hielscher
- Universitätsklinik für Frauenheilkunde, Mediznische Universität Wien
| | - J Metzler
- Universitätsklinik für Frauenheilkunde, Mediznische Universität Wien
| | - M Izsó
- Universitätsklinik für Frauenheilkunde, Mediznische Universität Wien
| | - C Trinkl
- Universitätsklinik für Frauenheilkunde, Mediznische Universität Wien
| | - C Singer
- Universitätsklinik für Frauenheilkunde, Mediznische Universität Wien
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Aronis J, Daigle K, Almaghasilah A, Gilbert C, Fremouw T, Singer C, Abedi A, Hayes M. 1146 Interaction Of Mild Cognitive Impairment And Late-life Depression In Actigraphy And Self Report Of Sleep Problems. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.1140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Late-life depression has been proposed as a precursor to amnestic Mild Cognitive Impairment (aMCI), the prodrome of Alzheimer’s disease. Both conditions are associated with sleep and cognitive problems. We hypothesized that MCI and current depressive symptoms would co-occur more frequently, but express distinct sleep phenotypes.
Methods
Independently living older adults (N=80), age 62-90 (M=71.78, SD=5.98), were recruited from a geriatric psychiatry clinic and the community for a home sleep study. A clinical decision board and neurocognitive battery were used to determine MCI status. Participants completed the CES-D and depression history interview where endorsement of current depression was considered positive. Sleep was examined with wrist actigraphy for 7 days. Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), Stanford Sleepiness Scale (SSS) provided subjective sleep quality.
Results
Based on these criteria, 41.2% of the sample were determined to be MCI (n=33); the remainder were deemed normative for age (NC; n=47). Chi-square analyses showed a higher frequency of MCI were positive for current depression than expected (14.2%; p=0.017). Repeated-measures MANOVA, using current depression symptoms and MCI as factors, revealed MCI was associated with longer sleep latency (p=0.035) and wake bout time (p=0.039); whereas, current depression was associated with longer sleep latency, more fragmentation/WASO, and lower sleep efficiency (p’s<0.05), self-report of poorer daytime dysfunction (p=0.005), and greater daytime sleepiness (p=0.001). MCI x current depression interactions were found for sleep latency (p=0.029); and PSQI sleep disturbances (p=0.005) and sleep medication (p=0.025).
Conclusion
Despite distinct sleep disordered phenotypes, the interaction of MCI and current depression is associated with delayed sleep onset, use sleep medication and report of sleep disturbances.
Support
This project was sponsored by: NASA, Maine Space Consortium; AG 056176, AG 053164 Vice President for Research, U. Maine; Maine Technology Institute; DoD Phase I SBIR and R44AG059536-01 SBIR Phase II Award.
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Affiliation(s)
- J Aronis
- University of Maine, Psychological Sciences, Orono, ME
| | - K Daigle
- University of Maine, Psychological Sciences, Orono, ME
| | - A Almaghasilah
- University of Maine, Electrical & Computer Engineering, Orono, ME
| | - C Gilbert
- University of Maine, Psychological Sciences, Orono, ME
| | - T Fremouw
- University of Maine, Psychological Sciences, Orono, ME
| | - C Singer
- Northern Light Acadia Hospital, Geriatric Psychiatry Program, Bangor, ME
| | - A Abedi
- University of Maine, Electrical & Computer Engineering, Orono, ME
| | - M Hayes
- University of Maine, Psychological Sciences, Orono, ME
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Bekos C, Grimm C, Paspalj V, Reinthaller A, Polterauer S, Müllauer L, Singer C. Vergleich der Detektionsraten von BRCA 1/2-Mutationen mittels Tumortestung versus Keimbahntestung bei Patientinnen mit epithelialem Ovarialkarzinom – eine retrospektive Datenanalyse. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0039-3403386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Affiliation(s)
- C Bekos
- Medizinische Universität Wien, Comprehensive Cancer Center, Universitätsklinik für Frauenheilkunde, Klinische Abteilung für Allgemeine Gynäkologie und gynäkologische Onkologie
| | - C Grimm
- Medizinische Universität Wien, Comprehensive Cancer Center, Universitätsklinik für Frauenheilkunde, Klinische Abteilung für Allgemeine Gynäkologie und gynäkologische Onkologie
| | - V Paspalj
- Medizinische Universität Wien, Comprehensive Cancer Center, Universitätsklinik für Frauenheilkunde, Klinische Abteilung für Allgemeine Gynäkologie und gynäkologische Onkologie
| | - A Reinthaller
- Medizinische Universität Wien, Comprehensive Cancer Center, Universitätsklinik für Frauenheilkunde, Klinische Abteilung für Allgemeine Gynäkologie und gynäkologische Onkologie
| | - S Polterauer
- Medizinische Universität Wien, Comprehensive Cancer Center, Universitätsklinik für Frauenheilkunde, Klinische Abteilung für Allgemeine Gynäkologie und gynäkologische Onkologie
| | - L Müllauer
- Medizinische Universität Wien, Klinisches Institut für Pathologie
| | - C Singer
- Medizinische Universität Wien, Comprehensive Cancer Center, Universitätsklinik für Frauenheilkunde, Klinische Abteilung für Allgemeine Gynäkologie und gynäkologische Onkologie
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Leser C, Reiner A, Dorffner G, Kastner MT, Igaz M, Singer C, Deutschmann C, Holzer I, Castillo DM, Gschwantler-Kaulich D. Expression von Biomarkern des Cyclin D-Cyclin dependent Kinase 4/6-Retinoblastompathways in tissue arrays von primären Brusttumoren und gematchten Lymphknotenmetastasen. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0039-3403393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Affiliation(s)
- C Leser
- Abteilung für Gynäkologie und geburtshilfe, Medizinische Universität Wien
| | - A Reiner
- Abteilung für Pathologie, Sozialmedizinisches Zentrum Ost, Wien
| | - G Dorffner
- Sektion für artifizielle Intelligenz, Medizinische Universität Wien
| | - M-T Kastner
- Abteilung für Gynäkologie und geburtshilfe, Medizinische Universität Wien
| | | | - C Singer
- Abteilung für Gynäkologie und geburtshilfe, Medizinische Universität Wien
| | - C Deutschmann
- Abteilung für Gynäkologie und geburtshilfe, Medizinische Universität Wien
| | - I Holzer
- Abteilung für Gynäkologie und geburtshilfe, Medizinische Universität Wien
| | - D M Castillo
- Abteilung für Gynäkologie und geburtshilfe, Medizinische Universität Wien
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16
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Danzinger S, Pfeifer C, Gscheidlinger P, Harrasser L, Kronawetter G, Behrendt S, Singer C. Lymphknotenstatus beim HER2-positiven Mammakarzinom und neoadjuvante Therapie. Geburtshilfe Frauenheilkd 2019. [DOI: 10.1055/s-0039-1693865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Affiliation(s)
- S Danzinger
- Universitätsklinik für Frauenheilkunde, Medizinische Universität Wien
| | - C Pfeifer
- Institut für Statistik, Universität Innsbruck
| | - P Gscheidlinger
- Institut für klinische Epidemiologie der Tirol Kliniken GmbH (IET), Innsbruck
| | - L Harrasser
- Institut für klinische Epidemiologie der Tirol Kliniken GmbH (IET), Innsbruck
| | - G Kronawetter
- Universitätsklinik für Frauenheilkunde, Medizinische Universität Wien
| | - S Behrendt
- Institut für klinische Epidemiologie der Tirol Kliniken GmbH (IET), Innsbruck
| | - C Singer
- Universitätsklinik für Frauenheilkunde, Medizinische Universität Wien
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17
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Filipits M, Dubsky P, Rudas M, Greil R, Balic M, Fitzal F, Bago-Horvath Z, Singer C, Hlauschek D, Kronenwett R, Bernhisel R, Lancaster J, Gnant M. Abstract P4-08-05: Prediction of distant recurrence using EndoPredict among women with ER-positive, HER2-negative breast cancer with a maximum follow-up of 16 years. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p4-08-05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: EndoPredict has been previously validated as a prognostic test in women with ER-positive, HER2-negative disease who received endocrine therapy only as part of the ABCSG6 and -8 trials. Here, we further evaluate the prognostic value of EndoPredict in this cohort with longer-term follow-up and compare 10-year distant recurrence (DR) and 5-15 years late recurrence according to nodal status.
Methods: This analysis included 1702 patients with ER-positive, HER2-negative disease who received endocrine therapy only. Prognostic value of EPclin score and EPclin risk category (high, low) on the risk of distant recurrence adjusted for patient and disease characteristics was evaluated using multivariable Cox proportional hazard models. Kaplan-Meier estimators were used to estimate DR according EPclin class and were compared using log rank test. Analyses were performed for the overall cohort, by nodal status, and for patients who were distant recurrence free at year 5 (late recurrence).
Results: The median follow-up was 9.6 years (range 0-16.6), an increase of 4.2 years over previous reports. Reanalysis with longer follow-up confirms that EPclin is a significant predictor of DR after adjusting for clinical factors, regardless of nodal status (Table 1). Overall, 62.6% of patients had low risk EPclin scores and 10-year DR was significantly improved relative to those with high risk scores (p<0.0001; Table 2). When nodal status was considered, 77.8% of node negative tumors and 34.9% of node positive (1-3 PLN) tumors had low risk EPclin scores. Regardless of nodal status, DR was significantly improved for those with low versus high risk EPclin scores (Table 2). Similar results were observed for the patients who were DR free at year 5 (5-15 year follow-up) (Table 2).
Conclusion: This reanalysis of previous EndoPredict data with a longer follow-up confirms that EPclin can identify a large group of patients at low risk of distant recurrence after 10 years who might be sufficiently treated with 5 years adjuvant endocrine therapy only, independent of nodal status. Replication of these results for the late distant recurrence between years 5-15 also shows that EPclin scores may also be informative in selecting patients who may safely forgo extended endocrine therapy.
Table 1.Multivariate analysis 0-15 year DR5-15 year DRCohortHR*p-valueHR*p-valueAll patients2.55<0.00012.56<0.0001Node negative1.680.00352.010.00881-3 positive nodes2.68<0.00013.430.0004*Hazard Ratio (HR) per unit score after adjusting for age, tumor grade, Ki67, ER, PR, and treatment
Table 2.DR according to EPclin score Low risk EPclinHigh risk EPclin CohortHR*%0-10 year DR (95% CI)%0-10 year DR (95% CI)Log-rank p-valueAll patients N=17024.7762.60.96 (0.94, 0.97)37.40.80 (0.77, 0.84)<0.0001Node negative N=11653.4777.80.96 (0.94, 0.97)22.20.87 (0.83, 0.92)<0.00011-3 positive nodes N=4533.6534.90.96 (0.92, 0.99)65.10.81 (0.76, 0.87)0.0003CohortHR*%5-15 year DR (95% CI)%5-15 year DR (95% CI)Log-rank p-valueAll patients N=13864.5264.70.96 (0.93, 0.98)35.30.84 (0.79, 0.90)<0.0001Node negative N=9753.7678.30.97 (0.95, 0.99)21.70.85 (0.75, 0.96)<0.00011-3 positive nodes N=3623.0036.50.87 (0.72, 1.00)63.50.84 (0.77, 0.92)0.0337*HR for EPclin high risk versus low risk
Citation Format: Filipits M, Dubsky P, Rudas M, Greil R, Balic M, Fitzal F, Bago-Horvath Z, Singer C, Hlauschek D, Kronenwett R, Bernhisel R, Lancaster J, Gnant M. Prediction of distant recurrence using EndoPredict among women with ER-positive, HER2-negative breast cancer with a maximum follow-up of 16 years [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P4-08-05.
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Affiliation(s)
- M Filipits
- Comprehensive Cancer Center, Institute of Cancer Research, Medical University of Vienna, Vienna, Austria; Klinik St. Anna, Breast Center, Luzern, Switzerland; Salzburg Cancer Research Institute, Cancer Cluster Salzburg, Paracelsus Medical University Salzburg, Salzburg, Austria; Medical University Graz, Graz, Austria; Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Clinical Statistics, Austrian Breast and Colorectal Cancer Study Group, Vienna, Austria; Myriad International GmbH, Cologne, Germany; Myriad Genetics, Inc., Salt Lake City
| | - P Dubsky
- Comprehensive Cancer Center, Institute of Cancer Research, Medical University of Vienna, Vienna, Austria; Klinik St. Anna, Breast Center, Luzern, Switzerland; Salzburg Cancer Research Institute, Cancer Cluster Salzburg, Paracelsus Medical University Salzburg, Salzburg, Austria; Medical University Graz, Graz, Austria; Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Clinical Statistics, Austrian Breast and Colorectal Cancer Study Group, Vienna, Austria; Myriad International GmbH, Cologne, Germany; Myriad Genetics, Inc., Salt Lake City
| | - M Rudas
- Comprehensive Cancer Center, Institute of Cancer Research, Medical University of Vienna, Vienna, Austria; Klinik St. Anna, Breast Center, Luzern, Switzerland; Salzburg Cancer Research Institute, Cancer Cluster Salzburg, Paracelsus Medical University Salzburg, Salzburg, Austria; Medical University Graz, Graz, Austria; Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Clinical Statistics, Austrian Breast and Colorectal Cancer Study Group, Vienna, Austria; Myriad International GmbH, Cologne, Germany; Myriad Genetics, Inc., Salt Lake City
| | - R Greil
- Comprehensive Cancer Center, Institute of Cancer Research, Medical University of Vienna, Vienna, Austria; Klinik St. Anna, Breast Center, Luzern, Switzerland; Salzburg Cancer Research Institute, Cancer Cluster Salzburg, Paracelsus Medical University Salzburg, Salzburg, Austria; Medical University Graz, Graz, Austria; Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Clinical Statistics, Austrian Breast and Colorectal Cancer Study Group, Vienna, Austria; Myriad International GmbH, Cologne, Germany; Myriad Genetics, Inc., Salt Lake City
| | - M Balic
- Comprehensive Cancer Center, Institute of Cancer Research, Medical University of Vienna, Vienna, Austria; Klinik St. Anna, Breast Center, Luzern, Switzerland; Salzburg Cancer Research Institute, Cancer Cluster Salzburg, Paracelsus Medical University Salzburg, Salzburg, Austria; Medical University Graz, Graz, Austria; Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Clinical Statistics, Austrian Breast and Colorectal Cancer Study Group, Vienna, Austria; Myriad International GmbH, Cologne, Germany; Myriad Genetics, Inc., Salt Lake City
| | - F Fitzal
- Comprehensive Cancer Center, Institute of Cancer Research, Medical University of Vienna, Vienna, Austria; Klinik St. Anna, Breast Center, Luzern, Switzerland; Salzburg Cancer Research Institute, Cancer Cluster Salzburg, Paracelsus Medical University Salzburg, Salzburg, Austria; Medical University Graz, Graz, Austria; Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Clinical Statistics, Austrian Breast and Colorectal Cancer Study Group, Vienna, Austria; Myriad International GmbH, Cologne, Germany; Myriad Genetics, Inc., Salt Lake City
| | - Z Bago-Horvath
- Comprehensive Cancer Center, Institute of Cancer Research, Medical University of Vienna, Vienna, Austria; Klinik St. Anna, Breast Center, Luzern, Switzerland; Salzburg Cancer Research Institute, Cancer Cluster Salzburg, Paracelsus Medical University Salzburg, Salzburg, Austria; Medical University Graz, Graz, Austria; Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Clinical Statistics, Austrian Breast and Colorectal Cancer Study Group, Vienna, Austria; Myriad International GmbH, Cologne, Germany; Myriad Genetics, Inc., Salt Lake City
| | - C Singer
- Comprehensive Cancer Center, Institute of Cancer Research, Medical University of Vienna, Vienna, Austria; Klinik St. Anna, Breast Center, Luzern, Switzerland; Salzburg Cancer Research Institute, Cancer Cluster Salzburg, Paracelsus Medical University Salzburg, Salzburg, Austria; Medical University Graz, Graz, Austria; Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Clinical Statistics, Austrian Breast and Colorectal Cancer Study Group, Vienna, Austria; Myriad International GmbH, Cologne, Germany; Myriad Genetics, Inc., Salt Lake City
| | - D Hlauschek
- Comprehensive Cancer Center, Institute of Cancer Research, Medical University of Vienna, Vienna, Austria; Klinik St. Anna, Breast Center, Luzern, Switzerland; Salzburg Cancer Research Institute, Cancer Cluster Salzburg, Paracelsus Medical University Salzburg, Salzburg, Austria; Medical University Graz, Graz, Austria; Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Clinical Statistics, Austrian Breast and Colorectal Cancer Study Group, Vienna, Austria; Myriad International GmbH, Cologne, Germany; Myriad Genetics, Inc., Salt Lake City
| | - R Kronenwett
- Comprehensive Cancer Center, Institute of Cancer Research, Medical University of Vienna, Vienna, Austria; Klinik St. Anna, Breast Center, Luzern, Switzerland; Salzburg Cancer Research Institute, Cancer Cluster Salzburg, Paracelsus Medical University Salzburg, Salzburg, Austria; Medical University Graz, Graz, Austria; Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Clinical Statistics, Austrian Breast and Colorectal Cancer Study Group, Vienna, Austria; Myriad International GmbH, Cologne, Germany; Myriad Genetics, Inc., Salt Lake City
| | - R Bernhisel
- Comprehensive Cancer Center, Institute of Cancer Research, Medical University of Vienna, Vienna, Austria; Klinik St. Anna, Breast Center, Luzern, Switzerland; Salzburg Cancer Research Institute, Cancer Cluster Salzburg, Paracelsus Medical University Salzburg, Salzburg, Austria; Medical University Graz, Graz, Austria; Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Clinical Statistics, Austrian Breast and Colorectal Cancer Study Group, Vienna, Austria; Myriad International GmbH, Cologne, Germany; Myriad Genetics, Inc., Salt Lake City
| | - J Lancaster
- Comprehensive Cancer Center, Institute of Cancer Research, Medical University of Vienna, Vienna, Austria; Klinik St. Anna, Breast Center, Luzern, Switzerland; Salzburg Cancer Research Institute, Cancer Cluster Salzburg, Paracelsus Medical University Salzburg, Salzburg, Austria; Medical University Graz, Graz, Austria; Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Clinical Statistics, Austrian Breast and Colorectal Cancer Study Group, Vienna, Austria; Myriad International GmbH, Cologne, Germany; Myriad Genetics, Inc., Salt Lake City
| | - M Gnant
- Comprehensive Cancer Center, Institute of Cancer Research, Medical University of Vienna, Vienna, Austria; Klinik St. Anna, Breast Center, Luzern, Switzerland; Salzburg Cancer Research Institute, Cancer Cluster Salzburg, Paracelsus Medical University Salzburg, Salzburg, Austria; Medical University Graz, Graz, Austria; Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Clinical Statistics, Austrian Breast and Colorectal Cancer Study Group, Vienna, Austria; Myriad International GmbH, Cologne, Germany; Myriad Genetics, Inc., Salt Lake City
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18
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Devyatko Y, Filipits M, Greil R, Balic M, Bago-Horvath Z, Singer C, Fitzal F, Steger G, Gray B, Ferree S, Fesl C, Soelkner L, von Minckwitz G, Gnant M. Abstract P1-17-05: The impact of clinical risk assessment versus PAM-50 ROR score on prognosis and therapeutic decision making in patients with hormone-receptor positive early stage breast cancer. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p1-17-05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Therapeutic recommendations for adjuvant treatment of hormone-receptor positive breast cancer patients depend on the individual recurrence risk. A number of genomic assays introduced to achieve this goal, but it's still questioned if they actually offer superior risk assessment compared to traditional risk evaluation by experienced clinicians. This study was designed to compare the prognostic accuracy of PAM-50 to clinical judgment.
Methods: Based on the real data of a large adjuvant trial cohort (ABCSG-8, postmenopausal HR positive breast cancer patients), we created online-questionnaires including demographic, histological, and local-therapy details, with and without results of PAM50 ROR score. Out of 14 international breast cancer experts asked for individual patient's risk evaluation (low, intermediate, high) and therapy recommendations, 9 completed the questionnaire.
Patient data were described by Kaplan-Meier estimates of distant disease free survival (DDFS) stratified by risk group. Cox regression models were compared using the Akaike Information Criterion (AIC).
Results: 10 years DDFS and hazard ratios for distant recurrences stratified by risk-group as estimated giving in Table 1:
10 years DDFS and hazard ratios for distant recurrences stratified by risk-group as estimated Low riskIntermediate riskHigh risk n (%)10y DDFS,%(95%CI)n (%)10y DDFS,%(95%CI)n (%)10y DDFS, %(95%CI) HR(95% CI) HR(95% CI) HR(95% CI)Clinical only: AIC 817.6269 (43)93.0(89.8-96.2)289 (46)89.7(85.9-93.5)73 (11)76.6(66.1-87.1) 0.68(0.39,1.20) 1 2.57(1.41,4.65)PAM50 ROR: AIC 804.8241 (34)96.5(93.1-99.1)210 (33)89.2(84.7-93.7)207 (33)82.5(76.9-88.2) 0.27(0.11,0.62) 1 1.66(0.99,2.78)Combined: AIC 813.4232 (37)95.7(93.0-98.5)282 (45)87.8(83.7-92.0)117 (18)81.7(74.2-89.2) 0.42(0.22,0.84) 1 1.90(1.11,3.24)
Adding genomic information to clinical risk factors leads to escalation of therapeutic recommendations (i.e. additional chemotherapy, extended adjuvant endocrine) in 20% of patients, and de-escalation in 13% of patients.
Conclusions: Clinical judgment accurately identified the patients at high risk of relapse, but was clearly inferior to multi-genomic testing using the PAM-50 ROR score in differentiating low from intermediate risk. Particularly when avoiding unnecessary escalated therapy is the strategic goal, the addition of PAM-50 testing to clinical judgment offers improved accuracy in predicting low vs. intermediate risk of breast cancer recurrence.
Citation Format: Devyatko Y, Filipits M, Greil R, Balic M, Bago-Horvath Z, Singer C, Fitzal F, Steger G, Gray B, Ferree S, Fesl C, Soelkner L, von Minckwitz G, Gnant M. The impact of clinical risk assessment versus PAM-50 ROR score on prognosis and therapeutic decision making in patients with hormone-receptor positive early stage breast cancer [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P1-17-05.
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Affiliation(s)
- Y Devyatko
- Medical University of Vienna, Vienna, Austria; Institute of Cancer Research and Comprehensive Cancer Center, Medical University of ViennaInstitute of Cancer Research and Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Paracelsus Medical University Salzburg and Salzburg Cancer Research Institute, Salzburg, Austria; Medical University of Graz, Graz, Austria; Clinical Institute of Pathology and Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; NanoString Technologies, Seattle, WA; Austrian Breast and Colorectal Cancer Study Group, Vienna, Austria; German Breast Group, Neu-Isenburg, Germany
| | - M Filipits
- Medical University of Vienna, Vienna, Austria; Institute of Cancer Research and Comprehensive Cancer Center, Medical University of ViennaInstitute of Cancer Research and Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Paracelsus Medical University Salzburg and Salzburg Cancer Research Institute, Salzburg, Austria; Medical University of Graz, Graz, Austria; Clinical Institute of Pathology and Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; NanoString Technologies, Seattle, WA; Austrian Breast and Colorectal Cancer Study Group, Vienna, Austria; German Breast Group, Neu-Isenburg, Germany
| | - R Greil
- Medical University of Vienna, Vienna, Austria; Institute of Cancer Research and Comprehensive Cancer Center, Medical University of ViennaInstitute of Cancer Research and Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Paracelsus Medical University Salzburg and Salzburg Cancer Research Institute, Salzburg, Austria; Medical University of Graz, Graz, Austria; Clinical Institute of Pathology and Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; NanoString Technologies, Seattle, WA; Austrian Breast and Colorectal Cancer Study Group, Vienna, Austria; German Breast Group, Neu-Isenburg, Germany
| | - M Balic
- Medical University of Vienna, Vienna, Austria; Institute of Cancer Research and Comprehensive Cancer Center, Medical University of ViennaInstitute of Cancer Research and Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Paracelsus Medical University Salzburg and Salzburg Cancer Research Institute, Salzburg, Austria; Medical University of Graz, Graz, Austria; Clinical Institute of Pathology and Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; NanoString Technologies, Seattle, WA; Austrian Breast and Colorectal Cancer Study Group, Vienna, Austria; German Breast Group, Neu-Isenburg, Germany
| | - Z Bago-Horvath
- Medical University of Vienna, Vienna, Austria; Institute of Cancer Research and Comprehensive Cancer Center, Medical University of ViennaInstitute of Cancer Research and Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Paracelsus Medical University Salzburg and Salzburg Cancer Research Institute, Salzburg, Austria; Medical University of Graz, Graz, Austria; Clinical Institute of Pathology and Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; NanoString Technologies, Seattle, WA; Austrian Breast and Colorectal Cancer Study Group, Vienna, Austria; German Breast Group, Neu-Isenburg, Germany
| | - C Singer
- Medical University of Vienna, Vienna, Austria; Institute of Cancer Research and Comprehensive Cancer Center, Medical University of ViennaInstitute of Cancer Research and Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Paracelsus Medical University Salzburg and Salzburg Cancer Research Institute, Salzburg, Austria; Medical University of Graz, Graz, Austria; Clinical Institute of Pathology and Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; NanoString Technologies, Seattle, WA; Austrian Breast and Colorectal Cancer Study Group, Vienna, Austria; German Breast Group, Neu-Isenburg, Germany
| | - F Fitzal
- Medical University of Vienna, Vienna, Austria; Institute of Cancer Research and Comprehensive Cancer Center, Medical University of ViennaInstitute of Cancer Research and Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Paracelsus Medical University Salzburg and Salzburg Cancer Research Institute, Salzburg, Austria; Medical University of Graz, Graz, Austria; Clinical Institute of Pathology and Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; NanoString Technologies, Seattle, WA; Austrian Breast and Colorectal Cancer Study Group, Vienna, Austria; German Breast Group, Neu-Isenburg, Germany
| | - G Steger
- Medical University of Vienna, Vienna, Austria; Institute of Cancer Research and Comprehensive Cancer Center, Medical University of ViennaInstitute of Cancer Research and Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Paracelsus Medical University Salzburg and Salzburg Cancer Research Institute, Salzburg, Austria; Medical University of Graz, Graz, Austria; Clinical Institute of Pathology and Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; NanoString Technologies, Seattle, WA; Austrian Breast and Colorectal Cancer Study Group, Vienna, Austria; German Breast Group, Neu-Isenburg, Germany
| | - B Gray
- Medical University of Vienna, Vienna, Austria; Institute of Cancer Research and Comprehensive Cancer Center, Medical University of ViennaInstitute of Cancer Research and Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Paracelsus Medical University Salzburg and Salzburg Cancer Research Institute, Salzburg, Austria; Medical University of Graz, Graz, Austria; Clinical Institute of Pathology and Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; NanoString Technologies, Seattle, WA; Austrian Breast and Colorectal Cancer Study Group, Vienna, Austria; German Breast Group, Neu-Isenburg, Germany
| | - S Ferree
- Medical University of Vienna, Vienna, Austria; Institute of Cancer Research and Comprehensive Cancer Center, Medical University of ViennaInstitute of Cancer Research and Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Paracelsus Medical University Salzburg and Salzburg Cancer Research Institute, Salzburg, Austria; Medical University of Graz, Graz, Austria; Clinical Institute of Pathology and Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; NanoString Technologies, Seattle, WA; Austrian Breast and Colorectal Cancer Study Group, Vienna, Austria; German Breast Group, Neu-Isenburg, Germany
| | - C Fesl
- Medical University of Vienna, Vienna, Austria; Institute of Cancer Research and Comprehensive Cancer Center, Medical University of ViennaInstitute of Cancer Research and Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Paracelsus Medical University Salzburg and Salzburg Cancer Research Institute, Salzburg, Austria; Medical University of Graz, Graz, Austria; Clinical Institute of Pathology and Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; NanoString Technologies, Seattle, WA; Austrian Breast and Colorectal Cancer Study Group, Vienna, Austria; German Breast Group, Neu-Isenburg, Germany
| | - L Soelkner
- Medical University of Vienna, Vienna, Austria; Institute of Cancer Research and Comprehensive Cancer Center, Medical University of ViennaInstitute of Cancer Research and Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Paracelsus Medical University Salzburg and Salzburg Cancer Research Institute, Salzburg, Austria; Medical University of Graz, Graz, Austria; Clinical Institute of Pathology and Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; NanoString Technologies, Seattle, WA; Austrian Breast and Colorectal Cancer Study Group, Vienna, Austria; German Breast Group, Neu-Isenburg, Germany
| | - G von Minckwitz
- Medical University of Vienna, Vienna, Austria; Institute of Cancer Research and Comprehensive Cancer Center, Medical University of ViennaInstitute of Cancer Research and Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Paracelsus Medical University Salzburg and Salzburg Cancer Research Institute, Salzburg, Austria; Medical University of Graz, Graz, Austria; Clinical Institute of Pathology and Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; NanoString Technologies, Seattle, WA; Austrian Breast and Colorectal Cancer Study Group, Vienna, Austria; German Breast Group, Neu-Isenburg, Germany
| | - M Gnant
- Medical University of Vienna, Vienna, Austria; Institute of Cancer Research and Comprehensive Cancer Center, Medical University of ViennaInstitute of Cancer Research and Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Paracelsus Medical University Salzburg and Salzburg Cancer Research Institute, Salzburg, Austria; Medical University of Graz, Graz, Austria; Clinical Institute of Pathology and Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; NanoString Technologies, Seattle, WA; Austrian Breast and Colorectal Cancer Study Group, Vienna, Austria; German Breast Group, Neu-Isenburg, Germany
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19
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Deutschmann C, Gschwantler-Kaulich D, Dorffner G, Singer C, Leser C, Kauer-Dorner D. Abstract P5-16-06: Prepectoral versus retropectoral implant-based breast reconstruction - The surgical and radiotherapeutical perspective. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p5-16-06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Subpectoral implant positioning has been the standard of care in breast reconstruction despite involving disadvantages owing to the detachment of the pectoralis major muscle such as disruption of the muscle function, animation deformities and prolonged postoperative pain. Refined ablative techniques as well as dermal matrices and synthetic mesh products have led to the reintroduction of subcutaneous implant-based breast reconstruction possibly avoiding the negative sequelae of pectoralis disinsertion.
Objective: The primary objective of this study was to compare procedure-related complication rates following prepectoral versus retropectoral implant-based breast reconstruction. Furthermore the effect of the implant position on the quality of post-mastectomy radiation therapy (PMRT) was analysed.
Methods: All patients who underwent an implant-based breast reconstruction after mastectomy at the Department of Obstetrics and Gynecology of the University Clinic of Vienna within the years 1.1.2013 to 31.12.2017 were included in the study. A retrospective chart review of the patients was conducted assessing parameters regarding the mastectomy, the reconstruction, complications following the reconstructive procedure, patient-associated risk factors and radiation treatment plans. Complication rates were analysed one week, one month and one year after the implant-based reconstructive operation.
Results: In total 57 patients (94 breasts) were reconstructed following a prepectoral implant-placement approach, 95 patients (149 breasts) were reconstructed with implants in a retropectoral position. The two patient cohorts did not differ significantly in the occurrence of complications including the following dehiscence, infection, seroma, secondary bleeding, necrosis, fistula, capsular contracture and rippling. No significant differences regarding reinterventions and reoperations including seroma drainage, secondary suture and reoperation following secondary hemorrhage and necrosis could be detected between the two study populations. The two surgical procedures were not associated with a different rate of implant loss.
12 (2 in the cohort of patients with prepectorally placed implants and 10 in the subgroup of patients with subpectorally positioned implants) out of 152 patients needed PMRT for oncological safety. Prepectoral versus retropectoral implant positioning did not affect breast Dmean or D90, heart Dmax or V5 or lung V20 across treatment plans.
Conclusion: The study demonstrated no inferior outcome regarding the occurrence of complications, reinterventions, reoperations and implant loss of prepectoral implant-based breast reconstruction compared to retropectoral implant positioning. Therefore, subcutaneous implant placement permits reconstruction of the breast with comparable procedure-related complication rates while avoiding disadvantages associated with the detachment of the pectoral muscle.
Regarding the radiation perspective both prepectoral and retropectoral implant positioning allow for optimal coverage of the chest wall with acceptable doses to the heart and lung.
Citation Format: Deutschmann C, Gschwantler-Kaulich D, Dorffner G, Singer C, Leser C, Kauer-Dorner D. Prepectoral versus retropectoral implant-based breast reconstruction - The surgical and radiotherapeutical perspective [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P5-16-06.
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Affiliation(s)
- C Deutschmann
- Medical University of Vienna, Vienna, Austria; Medical University of Vienna, Center for Medical Statistics, Informatics and Intelligent Systems, Section for Artificial Intelligence and Decision Support, Vienna, Austria
| | - D Gschwantler-Kaulich
- Medical University of Vienna, Vienna, Austria; Medical University of Vienna, Center for Medical Statistics, Informatics and Intelligent Systems, Section for Artificial Intelligence and Decision Support, Vienna, Austria
| | - G Dorffner
- Medical University of Vienna, Vienna, Austria; Medical University of Vienna, Center for Medical Statistics, Informatics and Intelligent Systems, Section for Artificial Intelligence and Decision Support, Vienna, Austria
| | - C Singer
- Medical University of Vienna, Vienna, Austria; Medical University of Vienna, Center for Medical Statistics, Informatics and Intelligent Systems, Section for Artificial Intelligence and Decision Support, Vienna, Austria
| | - C Leser
- Medical University of Vienna, Vienna, Austria; Medical University of Vienna, Center for Medical Statistics, Informatics and Intelligent Systems, Section for Artificial Intelligence and Decision Support, Vienna, Austria
| | - D Kauer-Dorner
- Medical University of Vienna, Vienna, Austria; Medical University of Vienna, Center for Medical Statistics, Informatics and Intelligent Systems, Section for Artificial Intelligence and Decision Support, Vienna, Austria
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20
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Filipits M, Rudas M, Singer C, Bago-Horvath Z, Greil R, Balic M, Lax S, Wu N, Zhao S, Weidler J, Bates M, Hlauschek D, Gnant M, Dubsky P. mRNA expression of ER, PR, HER2 and Ki67 are concordant to central ihc and predict clinical outcome: A validation study from the ABCSG-6 biomarker cohort. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy294.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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21
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Almaghasilah A, Daigle K, Gilbert C, Sulinski E, Aronis J, Bouchard A, Delp T, Singer C, Abedi A, Hayes M. 1014 Sleep Monitoring in Mild Cognitive Impairment Using Noninvasive, Under the Sheet Sensors. Sleep 2018. [DOI: 10.1093/sleep/zsy061.1013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- A Almaghasilah
- Electrical and Computer Engineering, University of Maine, Orono, ME
| | - K Daigle
- Psychological Sciences, University of Maine, Orono, ME
| | - C Gilbert
- Psychological Sciences, University of Maine, Orono, ME
| | - E Sulinski
- Psychological Sciences, University of Maine, Orono, ME
| | - J Aronis
- Psychological Sciences, University of Maine, Orono, ME
| | - A Bouchard
- Psychological Sciences, University of Maine, Orono, ME
| | - T Delp
- Psychological Sciences, University of Maine, Orono, ME
| | - C Singer
- Geriatric Neuropsychiatry Program, Acadia Hospital, Bangor, ME
| | - A Abedi
- Electrical and Computer Engineering, University of Maine, Orono, ME
| | - M Hayes
- Graduate School of Biomedical Sciences & Engineering, Orono, ME
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Steger G, Petru E, Haslbauer F, Marth C, Egle D, Galid A, Sliwa T, Lang A, Kuehr T, Petzer A, Ruckser R, Greil R, Mlineritsch B, Singer C, Seifert M, Andel J, Kwasny W, Pichler P, Tinchon C, Bartsch R. Real-World multicenter Austrian analysis of the safety and effectiveness of nab-paclitaxel in young and elderly patients with metastatic breast cancer. Eur J Cancer 2018. [DOI: 10.1016/s0959-8049(18)30519-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Rinnerthaler G, Gampenrieder SP, Petzer A, Pusch R, Fridrik M, Rossmann D, Balic M, Egle D, Rumpold H, Singer C, Bartsch R, Melchardt T, Ulmer H, Mlineritsch B, Greil R. Abstract OT2-07-11: Ixazomib in combination with carboplatin in pretreated women with advanced triple negative breast cancer, a phase I/II trial (AGMT MBC-10 trial). Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-ot2-07-11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Triple-negative breast cancer (TNBC) comprises a heterogeneous group of diseases which are generally associated with a poor prognosis. Up to now, no targeted treatment beyond anti-VEGF therapy is approved for TNBC so far and cytotoxic agents are the mainstay for the treatment of advanced tumor stages. Ixazomib is a selective, and reversible inhibitor of the proteasome, which has been mainly investigated in the treatment of multiple myeloma. In a preclinical study triple-negative breast cancer cells were treated with bortezomib, a first generation proteaseome inhibitor, alone and in combination with cisplatin, which had a synergistic effect. Clinical data are available for carboplatin plus bortezomib in metastatic ovarian and lung cancers showing remarkable antitumor activity and good tolerability. Based on this rational, the MBC-10 trial will evaluate the toxicity profile and efficacy of ixazomib in combination with carboplatin in patients with advanced TNBC.
Trial Design: Patients with metastatic TNBC pretreated with at least one prior line of chemotherapy for advanced disease with a confirmed disease progression and measurable disease are eligible for this study. Patients will receive ixazomib in combination with carboplatin on days 1, 8, and 15 in a 28-day cycle. The phase I part of this study uses an alternate dose escalation accelerated titration design. After establishing the maximum tolerated dose (MTD), accrual continues to evaluate the efficacy and safety of the combination (phase II, including 41 evaluable patients). All patients will continue on study drugs until disease progression, unacceptable toxicity or discontinuation for any other reason. Primary endpoint of the phase II is overall response rate, secondary endpoints include safety profile, progression-free survival and quality of life. This trial is open for patient enrollment since November 2016 in six Austrian cancer centers. Accrual is planned to be completed within two years. ClinicalTrials.gov Identifier: NCT02993094
Citation Format: Rinnerthaler G, Gampenrieder SP, Petzer A, Pusch R, Fridrik M, Rossmann D, Balic M, Egle D, Rumpold H, Singer C, Bartsch R, Melchardt T, Ulmer H, Mlineritsch B, Greil R. Ixazomib in combination with carboplatin in pretreated women with advanced triple negative breast cancer, a phase I/II trial (AGMT MBC-10 trial) [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr OT2-07-11.
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Affiliation(s)
- G Rinnerthaler
- Salzburg Cancer Research Institute with Laboratory of Immunological and Molecular Cancer Research and Center for Clinical Cancer and Immunology Trials, Paracelsus Medical University Salzburg, Salzburg, Austria; Barmherzige Schwestern Hospital Linz, Linz, Austria; Klinikum Wels-Grieskirchen, Wels, Austria; Johannes Kepler University Linz, Linz, Austria; County Hospital Steyr, Steyr, Austria; Medical University Graz, Graz, Austria; Innsbruck Medical University, Innsbruck, Austria; General Hospital Feldkirch, Feldkirch, Austria; Cancer Comprehensive Center, Medical University of Vienna, Vienna, Austria; Medical University Innsbruck, Innsbruck, Austria
| | - SP Gampenrieder
- Salzburg Cancer Research Institute with Laboratory of Immunological and Molecular Cancer Research and Center for Clinical Cancer and Immunology Trials, Paracelsus Medical University Salzburg, Salzburg, Austria; Barmherzige Schwestern Hospital Linz, Linz, Austria; Klinikum Wels-Grieskirchen, Wels, Austria; Johannes Kepler University Linz, Linz, Austria; County Hospital Steyr, Steyr, Austria; Medical University Graz, Graz, Austria; Innsbruck Medical University, Innsbruck, Austria; General Hospital Feldkirch, Feldkirch, Austria; Cancer Comprehensive Center, Medical University of Vienna, Vienna, Austria; Medical University Innsbruck, Innsbruck, Austria
| | - A Petzer
- Salzburg Cancer Research Institute with Laboratory of Immunological and Molecular Cancer Research and Center for Clinical Cancer and Immunology Trials, Paracelsus Medical University Salzburg, Salzburg, Austria; Barmherzige Schwestern Hospital Linz, Linz, Austria; Klinikum Wels-Grieskirchen, Wels, Austria; Johannes Kepler University Linz, Linz, Austria; County Hospital Steyr, Steyr, Austria; Medical University Graz, Graz, Austria; Innsbruck Medical University, Innsbruck, Austria; General Hospital Feldkirch, Feldkirch, Austria; Cancer Comprehensive Center, Medical University of Vienna, Vienna, Austria; Medical University Innsbruck, Innsbruck, Austria
| | - R Pusch
- Salzburg Cancer Research Institute with Laboratory of Immunological and Molecular Cancer Research and Center for Clinical Cancer and Immunology Trials, Paracelsus Medical University Salzburg, Salzburg, Austria; Barmherzige Schwestern Hospital Linz, Linz, Austria; Klinikum Wels-Grieskirchen, Wels, Austria; Johannes Kepler University Linz, Linz, Austria; County Hospital Steyr, Steyr, Austria; Medical University Graz, Graz, Austria; Innsbruck Medical University, Innsbruck, Austria; General Hospital Feldkirch, Feldkirch, Austria; Cancer Comprehensive Center, Medical University of Vienna, Vienna, Austria; Medical University Innsbruck, Innsbruck, Austria
| | - M Fridrik
- Salzburg Cancer Research Institute with Laboratory of Immunological and Molecular Cancer Research and Center for Clinical Cancer and Immunology Trials, Paracelsus Medical University Salzburg, Salzburg, Austria; Barmherzige Schwestern Hospital Linz, Linz, Austria; Klinikum Wels-Grieskirchen, Wels, Austria; Johannes Kepler University Linz, Linz, Austria; County Hospital Steyr, Steyr, Austria; Medical University Graz, Graz, Austria; Innsbruck Medical University, Innsbruck, Austria; General Hospital Feldkirch, Feldkirch, Austria; Cancer Comprehensive Center, Medical University of Vienna, Vienna, Austria; Medical University Innsbruck, Innsbruck, Austria
| | - D Rossmann
- Salzburg Cancer Research Institute with Laboratory of Immunological and Molecular Cancer Research and Center for Clinical Cancer and Immunology Trials, Paracelsus Medical University Salzburg, Salzburg, Austria; Barmherzige Schwestern Hospital Linz, Linz, Austria; Klinikum Wels-Grieskirchen, Wels, Austria; Johannes Kepler University Linz, Linz, Austria; County Hospital Steyr, Steyr, Austria; Medical University Graz, Graz, Austria; Innsbruck Medical University, Innsbruck, Austria; General Hospital Feldkirch, Feldkirch, Austria; Cancer Comprehensive Center, Medical University of Vienna, Vienna, Austria; Medical University Innsbruck, Innsbruck, Austria
| | - M Balic
- Salzburg Cancer Research Institute with Laboratory of Immunological and Molecular Cancer Research and Center for Clinical Cancer and Immunology Trials, Paracelsus Medical University Salzburg, Salzburg, Austria; Barmherzige Schwestern Hospital Linz, Linz, Austria; Klinikum Wels-Grieskirchen, Wels, Austria; Johannes Kepler University Linz, Linz, Austria; County Hospital Steyr, Steyr, Austria; Medical University Graz, Graz, Austria; Innsbruck Medical University, Innsbruck, Austria; General Hospital Feldkirch, Feldkirch, Austria; Cancer Comprehensive Center, Medical University of Vienna, Vienna, Austria; Medical University Innsbruck, Innsbruck, Austria
| | - D Egle
- Salzburg Cancer Research Institute with Laboratory of Immunological and Molecular Cancer Research and Center for Clinical Cancer and Immunology Trials, Paracelsus Medical University Salzburg, Salzburg, Austria; Barmherzige Schwestern Hospital Linz, Linz, Austria; Klinikum Wels-Grieskirchen, Wels, Austria; Johannes Kepler University Linz, Linz, Austria; County Hospital Steyr, Steyr, Austria; Medical University Graz, Graz, Austria; Innsbruck Medical University, Innsbruck, Austria; General Hospital Feldkirch, Feldkirch, Austria; Cancer Comprehensive Center, Medical University of Vienna, Vienna, Austria; Medical University Innsbruck, Innsbruck, Austria
| | - H Rumpold
- Salzburg Cancer Research Institute with Laboratory of Immunological and Molecular Cancer Research and Center for Clinical Cancer and Immunology Trials, Paracelsus Medical University Salzburg, Salzburg, Austria; Barmherzige Schwestern Hospital Linz, Linz, Austria; Klinikum Wels-Grieskirchen, Wels, Austria; Johannes Kepler University Linz, Linz, Austria; County Hospital Steyr, Steyr, Austria; Medical University Graz, Graz, Austria; Innsbruck Medical University, Innsbruck, Austria; General Hospital Feldkirch, Feldkirch, Austria; Cancer Comprehensive Center, Medical University of Vienna, Vienna, Austria; Medical University Innsbruck, Innsbruck, Austria
| | - C Singer
- Salzburg Cancer Research Institute with Laboratory of Immunological and Molecular Cancer Research and Center for Clinical Cancer and Immunology Trials, Paracelsus Medical University Salzburg, Salzburg, Austria; Barmherzige Schwestern Hospital Linz, Linz, Austria; Klinikum Wels-Grieskirchen, Wels, Austria; Johannes Kepler University Linz, Linz, Austria; County Hospital Steyr, Steyr, Austria; Medical University Graz, Graz, Austria; Innsbruck Medical University, Innsbruck, Austria; General Hospital Feldkirch, Feldkirch, Austria; Cancer Comprehensive Center, Medical University of Vienna, Vienna, Austria; Medical University Innsbruck, Innsbruck, Austria
| | - R Bartsch
- Salzburg Cancer Research Institute with Laboratory of Immunological and Molecular Cancer Research and Center for Clinical Cancer and Immunology Trials, Paracelsus Medical University Salzburg, Salzburg, Austria; Barmherzige Schwestern Hospital Linz, Linz, Austria; Klinikum Wels-Grieskirchen, Wels, Austria; Johannes Kepler University Linz, Linz, Austria; County Hospital Steyr, Steyr, Austria; Medical University Graz, Graz, Austria; Innsbruck Medical University, Innsbruck, Austria; General Hospital Feldkirch, Feldkirch, Austria; Cancer Comprehensive Center, Medical University of Vienna, Vienna, Austria; Medical University Innsbruck, Innsbruck, Austria
| | - T Melchardt
- Salzburg Cancer Research Institute with Laboratory of Immunological and Molecular Cancer Research and Center for Clinical Cancer and Immunology Trials, Paracelsus Medical University Salzburg, Salzburg, Austria; Barmherzige Schwestern Hospital Linz, Linz, Austria; Klinikum Wels-Grieskirchen, Wels, Austria; Johannes Kepler University Linz, Linz, Austria; County Hospital Steyr, Steyr, Austria; Medical University Graz, Graz, Austria; Innsbruck Medical University, Innsbruck, Austria; General Hospital Feldkirch, Feldkirch, Austria; Cancer Comprehensive Center, Medical University of Vienna, Vienna, Austria; Medical University Innsbruck, Innsbruck, Austria
| | - H Ulmer
- Salzburg Cancer Research Institute with Laboratory of Immunological and Molecular Cancer Research and Center for Clinical Cancer and Immunology Trials, Paracelsus Medical University Salzburg, Salzburg, Austria; Barmherzige Schwestern Hospital Linz, Linz, Austria; Klinikum Wels-Grieskirchen, Wels, Austria; Johannes Kepler University Linz, Linz, Austria; County Hospital Steyr, Steyr, Austria; Medical University Graz, Graz, Austria; Innsbruck Medical University, Innsbruck, Austria; General Hospital Feldkirch, Feldkirch, Austria; Cancer Comprehensive Center, Medical University of Vienna, Vienna, Austria; Medical University Innsbruck, Innsbruck, Austria
| | - B Mlineritsch
- Salzburg Cancer Research Institute with Laboratory of Immunological and Molecular Cancer Research and Center for Clinical Cancer and Immunology Trials, Paracelsus Medical University Salzburg, Salzburg, Austria; Barmherzige Schwestern Hospital Linz, Linz, Austria; Klinikum Wels-Grieskirchen, Wels, Austria; Johannes Kepler University Linz, Linz, Austria; County Hospital Steyr, Steyr, Austria; Medical University Graz, Graz, Austria; Innsbruck Medical University, Innsbruck, Austria; General Hospital Feldkirch, Feldkirch, Austria; Cancer Comprehensive Center, Medical University of Vienna, Vienna, Austria; Medical University Innsbruck, Innsbruck, Austria
| | - R Greil
- Salzburg Cancer Research Institute with Laboratory of Immunological and Molecular Cancer Research and Center for Clinical Cancer and Immunology Trials, Paracelsus Medical University Salzburg, Salzburg, Austria; Barmherzige Schwestern Hospital Linz, Linz, Austria; Klinikum Wels-Grieskirchen, Wels, Austria; Johannes Kepler University Linz, Linz, Austria; County Hospital Steyr, Steyr, Austria; Medical University Graz, Graz, Austria; Innsbruck Medical University, Innsbruck, Austria; General Hospital Feldkirch, Feldkirch, Austria; Cancer Comprehensive Center, Medical University of Vienna, Vienna, Austria; Medical University Innsbruck, Innsbruck, Austria
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Siegert S, Singer C, Molho E, Burke J, Liang G. Effects of once-daily valbenazine on Tardive Dyskinesia by body region. Parkinsonism Relat Disord 2018. [DOI: 10.1016/j.parkreldis.2017.11.087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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van Dam P, Tomatis M, Marotti L, Heil J, Mansel R, Rosselli del Turco M, van Dam P, Casella D, Bassani L, Danei M, Denk A, Egle D, Emons G, Friedrichs K, Harbeck N, Kiechle M, Kimmig R, Koehler U, Kuemmel S, Maass N, Mayr C, Prové A, Rageth C, Regolo L, Lorenz-Salehi F, Sarlos D, Singer C, Sohn C, Staelens G, Tinterri C, Audisio R, Ponti A, Badbanchi F, Catalano G, Cretella E, Daniaux M, Emons A, van Eygen K, Ettl J, Gatzemeier W, Kern P, Schneeweiss A, Stoeblen F, Van As A, Wuerstlein R, Zanini V. Time trends (2006–2015) of quality indicators in EUSOMA-certified breast centres. Eur J Cancer 2017; 85:15-22. [DOI: 10.1016/j.ejca.2017.07.040] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Revised: 05/31/2017] [Accepted: 07/25/2017] [Indexed: 12/21/2022]
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Castillo-Tong D, Von Der Decken I, Pfaffinger S, Wolf A, Kreuzinger C, Smeets D, Boeckx B, Lambrechts D, Singer C, Grimm C, Reinthaller A, Horvat R. New cell line models for the development of personalized therapy for high grade serous ovarian cancer. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx511.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Bartova M, Hlavaty J, Tan Y, Singer C, Pohlodek K, Luha J, Walter I. Expression of ezrin and moesin in primary breast carcinoma and matched lymph node metastases. Clin Exp Metastasis 2017. [PMID: 28624994 DOI: 10.1007/s10585-017-9853-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Ezrin, radixin, moesin (ERM) are important membrane-cytoskeletal crosslinkers and are suggested to play important role in cancer progression and metastasis. Even though ERM proteins were generally considered to be functionally redundant and the most studied was ezrin, recent studies highlight their distinct roles in metastatic process. Little information is available regarding the role of individual ERM proteins and their phosphorylated forms in human breast cancer. Our study is the first to examine expression of ezrin, moesin and their phosphorylated forms in primary breast tumors and matched lymph node metastases (LNMs) and their correlation with clinicopathological variables. A total of 88 primary breast cancer, 91 LNMs, 54 intraductal carcinoma and 26 normal adjacent breast tissue samples from tissue microarrays were studied. Expression was determined by immunohistochemistry, the intensity and number of positive cells was scored. Statistical analysis of protein expression and patients' age, tumor grade and hormonal status was performed. No statistical significant difference was found in ezrin, moesin, p-ezrinTyr353 and pan-p-ezrinThr567/radixinThr564/moesinThr558 expression between primary tumors and LNMs. Even though it was not significant, moesin expression varied between primary tumors, intraductal carcinoma, normal breast adjacent tissue and LNMs. A significant positive correlation between moesin and tumor grade has been proven. Even though primary tumors and matched LNMs did not show different expression patterns, moesin correlated significantly with higher tumor grade. Its positivity in intraductal carcinoma and normal breast tissue adjacent to cancer might indicate its role in tumor intiation/progression.
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Affiliation(s)
- M Bartova
- 2nd Department of Obstetrics and Gynecology, University Hospital Bratislava, Ružinovská 6, Bratislava, 826 06, Slovakia.
| | - J Hlavaty
- Department of Pathobiology, Institute of Anatomy, Histology and Embryology, University of Veterinary Medicine, Veterinärplatz 1, 1210, Vienna, Austria
| | - Y Tan
- Department of Obstetrics and Gynecology, Comprehensive Cancer Center, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.,QIMR Berghofer Medical Research Institute, 300 Herston Rd, Herston, QLD, 4006, Australia
| | - C Singer
- Division of General Gynecology and Gynecological Oncology, Department of Obstetrics and Gynecology, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - K Pohlodek
- 2nd Department of Obstetrics and Gynecology, University Hospital Bratislava, Ružinovská 6, Bratislava, 826 06, Slovakia
| | - J Luha
- Faculty of Medicine, Institute of Medical Biology, Genetics and Clinical Genetics, Comenius University Bratislava, Sasinkova 4, Bratislava, 811 08, Slovakia
| | - I Walter
- Department of Pathobiology, Institute of Anatomy, Histology and Embryology, University of Veterinary Medicine, Veterinärplatz 1, 1210, Vienna, Austria
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Gschwantler-Kaulich D, Schrenk P, Bjelic-Radisic V, Unterrieder K, Leser C, Fink-Retter A, Salama M, Singer C. Corrigendum to "Mesh versus acellular dermal matrix in immediate implant-based breast reconstruction - A prospective randomized trial" [Eur J Surg Oncol 42 (5) (2016) 665-671]. Eur J Surg Oncol 2017; 43:1380-1381. [PMID: 28526188 DOI: 10.1016/j.ejso.2017.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Affiliation(s)
- D Gschwantler-Kaulich
- Medical University of Vienna, Breast Cancer Center, Department of Gynaecological Oncology, Waehringer Guertel 18-20, 1090 Vienna, Austria.
| | - P Schrenk
- AKH Linz Breast Cancer Center, Krankenhausstrasse 9, 4021 Linz, Austria
| | - V Bjelic-Radisic
- Medical University of Graz, Department of Gynaecology, Auenbruggerplatz 1, 8036 Graz, Austria
| | - K Unterrieder
- Private Hospital Villach, Breast Cancer Center, Department of Gynaecology, Dr.-Walter-Hochsteiner-Straße 4, 9504 Villach, Austria
| | - C Leser
- Medical University of Vienna, Breast Cancer Center, Department of Gynaecological Oncology, Waehringer Guertel 18-20, 1090 Vienna, Austria
| | - A Fink-Retter
- Medical University of Vienna, Breast Cancer Center, Department of Gynaecological Oncology, Waehringer Guertel 18-20, 1090 Vienna, Austria
| | - M Salama
- Otto Wagner Hospital, Department of Surgery, Baumgartner Hoehe 1, 1140 Vienna, Austria
| | - C Singer
- Medical University of Vienna, Breast Cancer Center, Department of Gynaecological Oncology, Waehringer Guertel 18-20, 1090 Vienna, Austria
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Danzinger S, Tan Yen Y, Rudas M, Kastner MT, Weingartshofer S, Singer C. Phänotypische Subtypen von familiär bedingtem Brustkrebs. Geburtshilfe Frauenheilkd 2017. [DOI: 10.1055/s-0037-1602349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Affiliation(s)
| | - Y Tan Yen
- Universitätsklinik für Frauenheilkunde Wien
| | - M Rudas
- Universitätsklinik für Frauenheilkunde Wien
| | - MT Kastner
- Universitätsklinik für Frauenheilkunde Wien
| | | | - C Singer
- Universitätsklinik für Frauenheilkunde Wien
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Deutschmann C, Singer C. Eribulin – eine retrospektive Datenanalyse eines österreichischen Brustgesundheitszentrums. Geburtshilfe Frauenheilkd 2017. [DOI: 10.1055/s-0037-1602350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Affiliation(s)
| | - C Singer
- Universitätsklinik für Frauenheilkunde Wien
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Kotsopoulos J, Oden L, Akbari M, Singer C, Sun P, Salmena L, Narod S. Abstract P5-09-01: Plasma osteoprotegerin and the risk of breast cancer in BRCA1 and BRCA2 mutation carriers. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p5-09-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
This abstract was withdrawn by the authors.
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Affiliation(s)
- J Kotsopoulos
- Women's College Research Institute, Women's College Hospital, Toronto, ON, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada; Karolinska Institutet, Stockholm, Sweden; Medical University of Vienna, Vienna, Austria; University of Toronto, Toronto, ON, Canada
| | - L Oden
- Women's College Research Institute, Women's College Hospital, Toronto, ON, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada; Karolinska Institutet, Stockholm, Sweden; Medical University of Vienna, Vienna, Austria; University of Toronto, Toronto, ON, Canada
| | - M Akbari
- Women's College Research Institute, Women's College Hospital, Toronto, ON, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada; Karolinska Institutet, Stockholm, Sweden; Medical University of Vienna, Vienna, Austria; University of Toronto, Toronto, ON, Canada
| | - C Singer
- Women's College Research Institute, Women's College Hospital, Toronto, ON, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada; Karolinska Institutet, Stockholm, Sweden; Medical University of Vienna, Vienna, Austria; University of Toronto, Toronto, ON, Canada
| | - P Sun
- Women's College Research Institute, Women's College Hospital, Toronto, ON, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada; Karolinska Institutet, Stockholm, Sweden; Medical University of Vienna, Vienna, Austria; University of Toronto, Toronto, ON, Canada
| | - L Salmena
- Women's College Research Institute, Women's College Hospital, Toronto, ON, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada; Karolinska Institutet, Stockholm, Sweden; Medical University of Vienna, Vienna, Austria; University of Toronto, Toronto, ON, Canada
| | - S Narod
- Women's College Research Institute, Women's College Hospital, Toronto, ON, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada; Karolinska Institutet, Stockholm, Sweden; Medical University of Vienna, Vienna, Austria; University of Toronto, Toronto, ON, Canada
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Gschwantler-Kaulich E, Schrenk P, Bjelic-Radisic V, Unterrieder K, Leser C, Fink-Retter A, Salama M, Singer C. Mesh versus acellular dermal matrix in immediate implant based breast reconstruction – a prospective randomized trial. Eur J Cancer 2017. [DOI: 10.1016/s0959-8049(17)30176-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Steger G, Petru E, Haslbauer F, Egle D, Galid A, Sliwa T, Lang A, Kühr T, Petzer A, Ruckser R, Mlineritsch B, Greil R, Seifert M, Singer C, Andel J, Kwasny W, Marth C, Pichler P, Tinchon C, Bartsch R. Safety and effectiveness of nab-paclitaxel in young and elderly patients with metastatic breast cancer: a prospective, multicenter non-interventional study. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw365.20] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Singer C, Neagoe D, Coşoveanu S, Puiu I, Oancea G. Severe Toxocariasis in Children-Diagnostic Difficulties. Curr Health Sci J 2016; 42:413-416. [PMID: 30581597 PMCID: PMC6269623 DOI: 10.12865/chsj.42.04.12] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/03/2016] [Accepted: 12/09/2016] [Indexed: 11/18/2022]
Abstract
We present the case of an 18-month-old girl, from rural area, admitted to our clinic for fever and cough. The anamnestic data and the clinical and radiological examinations initially suggested the diagnosis of acute interstitial pneumonia. During hospitalization, she repeatedly presented exacerbations with acute respiratory failure, but without fever. Paraclinic examinations revealed anemia, leukocytosis, inflammatory tests with highly increased values, low values of serum iron and serum calcium, hyperproteinemia with hypergammaglobulinemia, the values of IgE and IgG being highly increased. Repeated pulmonary x-rays-peribronchovascular interstitial thickening, at the level of peri-and right infrahilar area. Medullary puncture-increased percentage of eosinophils in several stages of maturity, approximately 20%, normal values for the other medullary series, without atypical cells; the fingertip hemogram showed anemia, leukocytosis, eosinophilia. The diagnosis turned to a possible toxocariasis-atc anti toxocara canis=55.6 NTU. In the third week of hospitalization, the patient presented short crises of nonfebrile seizures. Normal CT and EEG brain. The child was discharged after 5 weeks, the diagnosis being severe toxocariasis with pulmonary and neurological manifestations; she was recommended an antiparasitary treatment and remained in our clinic's records.
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Affiliation(s)
- C Singer
- University of Medicine and Pharmacy of Craiova, Emergency County Hospital Craiova, 2nd Pediatric Clinic
| | - D Neagoe
- University of Medicine and Pharmacy of Craiova, Emergency County Hospital Craiova, Medical Clinic
| | - S Coşoveanu
- University of Medicine and Pharmacy of Craiova, Emergency County Hospital Craiova, 2nd Pediatric Clinic
| | - I Puiu
- University of Medicine and Pharmacy of Craiova, Emergency County Hospital Craiova, 1st Pediatric Clinic
| | - G Oancea
- Emergency County Hospital Craiova, 2nd Pediatric Clinic
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Gschwantler-Kaulich D, Schrenk P, Bjelic-Radisic V, Unterrieder K, Leser C, Fink-Retter A, Salama M, Singer C. Mesh versus acellular dermal matrix in immediate implant-based breast reconstruction - A prospective randomized trial. Eur J Surg Oncol 2016; 42:665-71. [PMID: 26947961 DOI: 10.1016/j.ejso.2016.02.007] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Revised: 01/21/2016] [Accepted: 02/02/2016] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Comparative studies on the use of meshes and acellular dermal matrices (ADM) in implant-based breast reconstruction (IBBR) have not yet been performed. METHODS This prospective, randomized, controlled, multicenter pilot study was performed at four Austrian breast cancer centers. Fifty patients with oncologic or prophylactic indication for mastectomy and IBBR were randomized to immediate IBBR with either an ADM (Protexa(®)) or a titanized mesh (TiLOOP(®) Bra). Complications, failed reconstruction, cosmetic outcome, patients' quality of life and the thickness of the overlying tissue were recorded immediately postoperatively and 3 and 6 months after surgery. RESULTS 48 patients participated in the study (Protexa(®) group: 23; TiLOOP(®) Bra group: 25 patients). The overall complication rate was 31.25% with similar rates in both groups (Protexa(®) group: 9 versus TiLOOP(®) Bra group: 6; p = 0.188). There was a higher incidence of severe complications leading to failed reconstructions with implant loss in the Protexa(®) group than in the TiLOOP(®) Bra group (7 versus 2; p < 0.0001). An inverted T-incision technique led to significantly more complications and reconstructive failure with Protexa(®) (p = 0.037, p = 0.012, respectively). There were no significant differences in patients' satisfaction with cosmetic results (p = 0.632), but surgeons and external specialists graded significantly better outcomes with TiLOOP(®) Bra (p = 0.034, p = 0.032). CONCLUSION This pilot study showed use of TiLOOP(®) Bra or Protexa(®) in IBBR is feasible leading to good cosmetic outcomes and high patient satisfaction. To validate the higher failure rates in the Protexa(®) group, data from a larger trial are required. NCT02562170.
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Affiliation(s)
- D Gschwantler-Kaulich
- Medical University of Vienna, Breast Cancer Center, Department of Gynaecological Oncology, Waehringer Guertel 18-20, 1090 Vienna, Austria.
| | - P Schrenk
- AKH Linz Breast Cancer Center, Krankenhausstrasse 9, 4021 Linz, Austria
| | - V Bjelic-Radisic
- Medical University of Graz, Department of Gynaecology, Auenbruggerplatz 1, 8036 Graz, Austria
| | - K Unterrieder
- Private Hospital Villach, Breast Cancer Center, Department of Gynaecology, Dr.-Walter-Hochsteiner-Straße 4, 9504 Villach, Austria
| | - C Leser
- Medical University of Vienna, Breast Cancer Center, Department of Gynaecological Oncology, Waehringer Guertel 18-20, 1090 Vienna, Austria
| | - A Fink-Retter
- Medical University of Vienna, Breast Cancer Center, Department of Gynaecological Oncology, Waehringer Guertel 18-20, 1090 Vienna, Austria
| | - M Salama
- Otto Wagner Hospital, Department of Surgery, Baumgartner Hoehe 1, 1140 Vienna, Austria
| | - C Singer
- Medical University of Vienna, Breast Cancer Center, Department of Gynaecological Oncology, Waehringer Guertel 18-20, 1090 Vienna, Austria
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Singer C, Coşoveanu S, Stoica LE, Georgescu DM, Puiu I, Neagoe D, Dragomir F. Psoriasis Vulgaris in Children - Case Presentation. Curr Health Sci J 2016; 42:97-101. [PMID: 30568819 PMCID: PMC6256140 DOI: 10.12865/chsj.42.01.14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Accepted: 03/10/2016] [Indexed: 11/18/2022]
Abstract
A seven-year-old girl, with erythematous-squamous rash, was admitted to our clinic to decide upon the diagnosis and treatment, being transferred from a county hospital. Heredo-collateral antecedents - an aunt, related to her mother, with psoriasis. When admitted, the patient presented prominent non-pruriginous erythematous plaques, clearly marked and covered by thick, silvery-white scales, easily exfoliating, all over at the level of: scalp, earlobes, neck, torso, limbs, periungual, axillary and genital areas. The dermatological examination: psoriasis vulgaris in patches and plaques, a diagnosis also confirmed histopathologically. Using a local dermatologic treatment, the evolution was favorable, the patient initially presenting thick squamae, then, gradually, there occurred the psoriasis whitening. We presented this case since psoriasis is rarely met at this early age.
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Affiliation(s)
- C Singer
- University of Medicine and Pharmacy of Craiova, Emergency County Hospital Craiova, 2nd Pediatric Clinic
| | - S Coşoveanu
- University of Medicine and Pharmacy of Craiova, Emergency County Hospital Craiova, 2nd Pediatric Clinic
| | - L E Stoica
- University of Medicine and Pharmacy of Craiova, Emergency County Hospital Craiova, Dermatology Clinic
| | - D M Georgescu
- University of Medicine and Pharmacy of Craiova, student
| | - I Puiu
- University of Medicine and Pharmacy of Craiova, Emergency County Hospital Craiova, 1st Pediatric Clinic
| | - D Neagoe
- University of Medicine and Pharmacy of Craiova, Emergency County Hospital Craiova, Medical Clinic
| | - F Dragomir
- Emergency County Hospital Craiova, 2nd Pediatric Clinic
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van Dam P, Tomatis M, Marotti L, Heil J, Wilson R, Rosselli del Turco M, Mayr C, Costa A, Danei M, Denk A, Emons G, Friedrichs K, Harbeck N, Kiechle M, Koheler U, Kuemmel S, Maass N, Marth C, Prové A, Kimmig R, Rageth C, Regolo L, Salehi L, Sarlos D, Singer C, Sohn C, Staelens G, Tinterri C, Ponti A, Cretella E, Kern P, Stoeblen F, Emons A, van Eygen K, Ettl J, Zanini V, Van As A, Daniaux M, Gatzemeier W, Catalano G, Schneeweiss A, Wuerstlein R. The effect of EUSOMA certification on quality of breast cancer care. Eur J Surg Oncol 2015; 41:1423-9. [DOI: 10.1016/j.ejso.2015.06.006] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2015] [Revised: 06/04/2015] [Accepted: 06/12/2015] [Indexed: 12/12/2022] Open
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Obermayr E, Maritschnegg E, Speiser P, Singer C, Schuster E, Holzer B, Danzinger S, Pecha N, Newland A, O'Brien M, Zeillinger R. 454 Circulating rare cells enable highly efficient cancer detection. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)30288-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Margolis NE, Bassiri-Tehrani B, Chhor C, Singer C, Hernandez O, Moy L. Polyacrylamide gel breast augmentation: report of two cases and review of the literature. Clin Imaging 2014; 39:339-43. [PMID: 25670236 DOI: 10.1016/j.clinimag.2014.12.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2014] [Revised: 11/25/2014] [Accepted: 12/12/2014] [Indexed: 12/17/2022]
Abstract
Polyacrylamide gel (PAAG) injection remains an uncommon method of breast augmentation. Providers must recognize the clinical and radiological manifestations to optimize management. The clinical and radiological findings of PAAG injection may mimic malignancy and silicone breast augmentation. We described two patients with prior PAAG breast augmentation with physical exam and imaging findings concerning for malignancy. We reviewed the literature on PAAG breast augmentation and compare PAAG to silicone breast augmentation. The management of such patients is discussed.
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Affiliation(s)
- Nathaniel E Margolis
- Department of Radiology, New York University Langone Medical Center, New York, NY USA.
| | | | - Chloe Chhor
- Department of Radiology, New York University Langone Medical Center, New York, NY USA.
| | - Cory Singer
- Department of Radiology, New York University Langone Medical Center, New York, NY USA.
| | - Osvaldo Hernandez
- Department of Pathology, New York University Langone Medical Center, New York, NY USA.
| | - Linda Moy
- Department of Radiology, New York University Langone Medical Center, New York, NY USA.
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Steger G, Greil R, Hubalek M, Fridrik M, Singer C, Bartsch R, Balic M, Dubsky P, Egle D, Gampenrieder S, Pfeiler G, Mayr D, Czech T, Rinnerthaler G, Petzer A, Sevelda P, Lang A, Frantal S, Rudas M, Gnant M. Docetaxel + Trastuzumab +/- Non-Pegylated Liposomal Doxorubicin +/- Bevacizumab in the Neoadjuvant Treatment of Early, Her2-Positive Breast Cancer: First Results of Abcsg-32. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu327.10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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42
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Exner R, Bago-Horvath Z, Bartsch R, Mittlboeck M, Retèl VP, Fitzal F, Rudas M, Singer C, Pfeiler G, Gnant M, Jakesz R, Dubsky P. The multigene signature MammaPrint impacts on multidisciplinary team decisions in ER+, HER2- early breast cancer. Br J Cancer 2014; 111:837-42. [PMID: 25003667 PMCID: PMC4150264 DOI: 10.1038/bjc.2014.339] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2014] [Revised: 05/15/2014] [Accepted: 05/26/2014] [Indexed: 12/17/2022] Open
Abstract
Background: Validated multigene signatures (MGS) provide additional prognostic information when evaluating clinical features of ER+, HER2− early breast cancer. We have studied the quantitative and qualitative impact of MGS on multidisciplinary team (MDT) recommendations. Methods: We prospectively recruited 75 ER+, HER2− breast cancer patients. Inclusion was based on biopsy assessment of grade, hormone receptor status, HER2, clinical tumour and nodal status. A fresh tissue sample was sent for MammaPrint (MP), TargetPrint analysis at surgery. Clinical risk was decided by the MDT in the absence of MP results and repeated following the collection of MP results. Decision changes were recorded and a health technology assessment was undertaken to compare cost effectiveness. Results: The majority of patients were assigned low to intermediate clinical risk by the MDT. According to MP, 76% were low risk. A very high correlation between local IHC and the TargetPrint assessment was shown. In over a third of patients, discordance between clinical and molecular risk was observed. Decision changes were recorded in half of these cases (18.6%) and resulted in two out of three patients not requiring chemotherapy. The use of MP was also found to be more cost effective. Conclusions: The multigene signature MP revealed clinical and molecular risk discordance in a third of patients. The impact of this on MDT recommendations was most profound in cases where few clinical risk factors were observed and enabled some women to forgo chemotherapy. The use of MGS is unlikely to have an impact in either clinically low-risk women or in patients with more than one relative indication for chemotherapy.
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Affiliation(s)
- R Exner
- Department of Surgery, Medical University of Vienna and Comprehensive Cancer Centre Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria
| | - Z Bago-Horvath
- Clinical Institute of Pathology, Medical University of Vienna and Comprehensive Cancer Centre Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria
| | - R Bartsch
- Clinical Division of Oncology, Department of Medicine I, Medical University of Vienna and Comprehensive Cancer Centre Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria
| | - M Mittlboeck
- Department of Statistics and Intelligent Systems, Medical University of Vienna and Comprehensive Cancer Centre Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria
| | - V P Retèl
- Netherlands Cancer Institute, Department of Psychosocial Research and Epidemiology, Amsterdam, The Netherlands
| | - F Fitzal
- Department of Surgery, Medical University of Vienna and Comprehensive Cancer Centre Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria
| | - M Rudas
- Clinical Institute of Pathology, Medical University of Vienna and Comprehensive Cancer Centre Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria
| | - C Singer
- Department of Gynaecology and Obstetrics, Medical University of Vienna and Comprehensive Cancer Centre Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria
| | - G Pfeiler
- Department of Gynaecology and Obstetrics, Medical University of Vienna and Comprehensive Cancer Centre Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria
| | - M Gnant
- Department of Surgery, Medical University of Vienna and Comprehensive Cancer Centre Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria
| | - R Jakesz
- Department of Surgery, Medical University of Vienna and Comprehensive Cancer Centre Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria
| | - P Dubsky
- Department of Surgery, Medical University of Vienna and Comprehensive Cancer Centre Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria
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Ott J, Bartsch R, Dubsky P, Singer C, Promberger R. Postoperative Extension einer neoadjuvanten Chemotherapie bei Brustkrebspatientinnen – eine retrospektive Analyse. Geburtshilfe Frauenheilkd 2014. [DOI: 10.1055/s-0034-1374762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Moonen AJH, Wijers A, Leentjens AFG, Christine CW, Factor SA, Juncos J, Lyness JM, Marsh L, Panisset M, Pfeiffer R, Rottenberg D, Serrano Ramos C, Shulman L, Singer C, Slevin J, McDonald W, Auinger P, Richard IH. Severity of depression and anxiety are predictors of response to antidepressant treatment in Parkinson's disease. Parkinsonism Relat Disord 2014; 20:644-6. [PMID: 24679737 DOI: 10.1016/j.parkreldis.2014.02.025] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2014] [Revised: 02/21/2014] [Accepted: 02/24/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND Antidepressants have appeared to be more effective than placebo treatment in treating depressive syndromes in patients with Parkinson's disease (PD). OBJECTIVE To identify factors that predict improvement in depressive symptoms during antidepressant treatment in depressed PD patients. METHODS A secondary analysis was performed on the dataset of the Randomized Placebo-controlled Study of Antidepressants in PD (SAD-PD), in which 76 patients received active treatment with either paroxetine or venlafaxine extended release (XR), and 39 patients received placebo treatment. Backward stepwise regression analyses were conducted with change in 24-item Hamilton Depression Rating Scale (HAMD-24) score between assessments at baseline and week 12 as the main outcome measure, and sex, age, baseline HAMD-24 score, Unified Parkinson's Disease Rating Scale section III (UPDRS-III) score, Mini-Mental State Examination (MMSE), and the Clinical Anxiety Scale (CAS) as independent variables. RESULTS In both the active treatment and placebo groups, higher baseline HAMD-24 score and lower UPDRS-III score were associated with greater reduction in HAMD-24 score. Higher anxiety scores predicted less response in the active treatment group. Higher MMSE scores predicted greater response only in the placebo-treated group. Sex and age were no predictors of response. CONCLUSIONS Higher pre-treatment depression scores and lower pre-treatment anxiety scores are the two most important predictors for improvement during antidepressant treatment in depressed PD patients, which is in line with those found in treatment studies of depressed non-PD patients. Furthermore, our results indicate the requirement for different or more intensive treatment for depressed PD patients with more severe anxiety symptoms.
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Affiliation(s)
- A J H Moonen
- Department of Psychiatry, Maastricht University, Maastricht, The Netherlands.
| | - A Wijers
- Department of Psychiatry, Maastricht University, Maastricht, The Netherlands
| | - A F G Leentjens
- Department of Psychiatry, Maastricht University, Maastricht, The Netherlands
| | - C W Christine
- Department of Neurology, University of California, San Francisco, San Francisco, CA, USA
| | - S A Factor
- Department of Neurology, Emory University, Atlanta, GA, USA
| | - J Juncos
- Department of Neurology, Emory University, Atlanta, GA, USA
| | - J M Lyness
- University of Rochester School of Medicine and Dentistry, Rochester, NY, USA
| | - L Marsh
- Mental Health Care Line, Michael E. DeBakey Veterans Administration Medical Center, Houston, USA; Department of Psychiatry, Baylor College of Medicine, Houston, USA; Department of Neurology, Baylor College of Medicine, Houston, USA
| | - M Panisset
- Department of Neurology, University of Montreal, Montreal, Canada
| | - R Pfeiffer
- Department of Neurology, University of Tennessee Health Science Center, Memphis, TN, USA
| | - D Rottenberg
- Department of Neurology, University of Minnesota, Minneapolis, MN, USA; Department of Radiology, University of Minnesota, Minneapolis, MN, USA
| | | | - L Shulman
- Department of Neurology, University of Maryland School of Medicine, Baltimore, USA
| | - C Singer
- Department of Neurology, Leonard M. Miller School of Medicine, University of Miami, Miami, FL, USA
| | - J Slevin
- Department of Neurology, University of Kentucky College of Medicine, Lexington, KY, USA
| | - W McDonald
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, USA
| | - P Auinger
- University of Rochester School of Medicine and Dentistry, Rochester, NY, USA
| | - I H Richard
- University of Rochester School of Medicine and Dentistry, Rochester, NY, USA
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Martínez-Martín P, Rodríguez-Blázquez C, Forjaz MJ, Alvarez-Sánchez M, Arakaki T, Bergareche-Yarza A, Chade A, Garretto N, Gershanik O, Kurtis MM, Martínez-Castrillo JC, Mendoza-Rodríguez A, Moore HP, Rodríguez-Violante M, Singer C, Tilley BC, Huang J, Stebbins GT, Goetz CG. Relationship between the MDS-UPDRS domains and the health-related quality of life of Parkinson's disease patients. Eur J Neurol 2014; 21:519-24. [PMID: 24447695 DOI: 10.1111/ene.12349] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2013] [Accepted: 12/11/2013] [Indexed: 10/25/2022]
Abstract
BACKGROUND AND PURPOSE The Movement Disorder Society sponsored version of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS) is a comprehensive instrument for assessing Parkinson's disease (PD). The present study was aimed at determining the relationships between MDS-UPDRS components and health-related quality of life (HRQoL) evaluations in PD patients. METHODS An international, multicenter, cross-sectional study was carried out of 435 PD patients assessed with the MDS-UPDRS, Hoehn and Yahr (HY), Clinical Impression Severity for PD, EQ-5D and PD Questionnaire - eight items (PDQ-8). Spearman's rank correlation coefficients, exploratory factor analysis and multiple linear regression models (dependent variables EQ-5D and PDQ-8) were performed. RESULTS The participants' age was 66.71 ± 10.32 years (51.5% men). PD duration was 8.52 ± 6.14, and median HY was 2 (range 1-5). The correlation between the EQ-5D index and the MDS-UPDRS ranged from -0.46 (Part IV) to -0.72 (Part II) and for the PDQ-8 index from 0.47 (Part III) to 0.74 (Part II). In multiple regression models with the MDS-UPDRS domains as independent variables, the main determinant for both the EQ-5D index and the PDQ-8 was Part II followed by Part I. After factorial grouping of the cardinal PD manifestations embedded in the MDS-UPDRS Parts III and IV for inclusion into multiple regression models, a factor formed by M-EDL, nM-EDL and fluctuations was the main determinant for both the EQ-5D and PDQ-8 indexes. CONCLUSIONS The MDS-UPDRS component most tightly related with the HRQoL measures was a combination of motor and non-motor experiences of daily living.
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Affiliation(s)
- P Martínez-Martín
- Alzheimer Center Reina Sofia Foundation and CIBERNED, Carlos III Institute of Health, Madrid, Spain
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Schenck C, Montplaisir J, Frauscher B, Hogl B, Gagnon JF, Postuma R, Sonka K, Jennum P, Partinen M, Arnulf I, de Cock VC, Dauvilliers Y, Luppi PH, Heidbreder A, Mayer G, Sixel-Döring F, Trenkwalder C, Unger M, Young P, Wing Y, Ferini-Strambi L, Ferri R, Plazzi G, Zucconi M, Inoue Y, Iranzo A, Santamaria J, Bassetti C, Möller J, Boeve B, Lai Y, Pavlova M, Saper C, Schmidt P, Siegel J, Singer C, St Louis E, Videnovic A, Oertel W. Corrigendum to “Rapid eye movement sleep behavior disorder: devising controlled active treatment studies for symptomatic and neuroprotective therapy—a consensus statement from the International Rapid Eye Movement Sleep Behavior Disorder Study Group” [Sleep Med 14(8) (2013) 795–806]. Sleep Med 2014. [DOI: 10.1016/j.sleep.2013.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Gnant M, Filipits M, Greil R, Stoeger H, Rudas M, Bago-Horvath Z, Mlineritsch B, Kwasny W, Knauer M, Singer C, Jakesz R, Dubsky P, Fitzal F, Bartsch R, Steger G, Balic M, Ressler S, Cowens JW, Storhoff J, Ferree S, Schaper C, Liu S, Fesl C, Nielsen TO. Predicting distant recurrence in receptor-positive breast cancer patients with limited clinicopathological risk: using the PAM50 Risk of Recurrence score in 1478 postmenopausal patients of the ABCSG-8 trial treated with adjuvant endocrine therapy alone. Ann Oncol 2013; 25:339-45. [PMID: 24347518 DOI: 10.1093/annonc/mdt494] [Citation(s) in RCA: 256] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND PAM50 is a 50-gene test that is designed to identify intrinsic breast cancer subtypes and generate a Risk of Recurrence (ROR) score. It has been developed to be carried out in qualified routine hospital pathology laboratories. PATIENTS AND METHODS One thousand four hundred seventy-eight postmenopausal women with estrogen receptor (ER)+ early breast cancer (EBC) treated with tamoxifen or tamoxifen followed by anastrozole from the prospective randomized ABCSG-8 trial were entered into this study. Patients did not receive adjuvant chemotherapy. RNA was extracted from paraffin blocks and analyzed using the PAM50 test. Both intrinsic subtype (luminal A/B, HER2-enriched, basal-like) and ROR score were calculated. The primary analysis was designed to test whether the continuous ROR score adds prognostic value in predicting distant recurrence (DR) over and above standard clinical variables. RESULTS In all tested subgroups, ROR score significantly adds prognostic information to the clinical predictor (P<0.0001). PAM50 assigns an intrinsic subtype to all cases, and the luminal A cohort had a significantly lower ROR at 10 years compared with Luminal B (P<0.0001). Significant and clinically relevant discrimination between low- and high-risk groups occurred also within all tested subgroups. CONCLUSION(S) The results of the primary analysis, in combination with recently published results from the ATAC trial, constitute Level 1 evidence for clinical validity of the PAM50 test for predicting the risk of DR in postmenopausal women with ER+ EBC. A 10-year metastasis risk of <3.5% in the ROR low category makes it unlikely that additional chemotherapy would improve this outcome-this finding could help to avoid unwarranted overtreatment. CLINICAL TRIAL NUMBER ABCSG 8: NCT00291759.
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Affiliation(s)
- M Gnant
- Department of Surgery and Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
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Pfeiler G, Königsberg R, Hadji P, Fitzal F, Maroske M, Dressel-Ban G, Zellinger J, Exner R, Seifert M, Singer C, Gnant M, Dubsky P. Impact of body mass index on estradiol depletion by aromatase inhibitors in postmenopausal women with early breast cancer. Br J Cancer 2013; 109:1522-7. [PMID: 24002592 PMCID: PMC3777005 DOI: 10.1038/bjc.2013.499] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2013] [Revised: 07/26/2013] [Accepted: 07/30/2013] [Indexed: 01/08/2023] Open
Abstract
Background: Body mass index (BMI) has an impact on survival outcome in patients treated with aromatase inhibitors (AIs). Obesity is associated with an increased body aromatisation and may be a cause of insufficient estradiol depletion. Methods: Sixty-eight postmenopausal oestrogen receptor-positive patients with early breast cancer were prospectively included in this study. Follicle stimulating hormone (FSH), luteinizing hormone (LH) and estradiol were analysed immediately in the clinical routine lab and in a dedicated central lab before (T1) and 3 months after start with aromatase inhibitors (T2). Results: A total of 40 patients were normal or overweight (non-obese: BMI 18.5–29.9 kg m−2) and 28 were obese (BMI⩾30 kg m−2). Aromatase inhibitors significantly suppressed estradiol serum levels (T1: 19.5 pg ml−1, T2: 10.5 pg ml−1, P<0.01) and increased FSH serum levels (T1: 70.2 mIU ml−1, T2: 75.7 mIU ml−1, P<0.05). However, after 3 months of AI treatment, estradiol levels of obese patients were nonsignificantly higher compared with non-obese patients (12.5 pg ml−1vs 9.0 pg ml−1, P=0.1). This difference was reflected by significantly lower FSH serum levels in obese compared with non-obese patients (65.5 mIU ml−1vs 84.6 mIU ml−1, P<0.01). The significant effects of BMI on FSH serum levels could be detected both in the routine as well as in the dedicated central lab. Conclusion: Aromatase inhibitors are less efficient at suppressing estradiol serum levels in obese when compared with non-obese women.
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Affiliation(s)
- G Pfeiler
- Division of Gynecology and Gynecological Oncology, Department of OB/GYN, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
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Schenck CH, Montplaisir JY, Frauscher B, Hogl B, Gagnon JF, Postuma R, Sonka K, Jennum P, Partinen M, Arnulf I, Cochen de Cock V, Dauvilliers Y, Luppi PH, Heidbreder A, Mayer G, Sixel-Döring F, Trenkwalder C, Unger M, Young P, Wing YK, Ferini-Strambi L, Ferri R, Plazzi G, Zucconi M, Inoue Y, Iranzo A, Santamaria J, Bassetti C, Möller JC, Boeve BF, Lai YY, Pavlova M, Saper C, Schmidt P, Siegel JM, Singer C, St Louis E, Videnovic A, Oertel W. Rapid eye movement sleep behavior disorder: devising controlled active treatment studies for symptomatic and neuroprotective therapy--a consensus statement from the International Rapid Eye Movement Sleep Behavior Disorder Study Group. Sleep Med 2013; 14:795-806. [PMID: 23886593 DOI: 10.1016/j.sleep.2013.02.016] [Citation(s) in RCA: 163] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2012] [Revised: 01/25/2013] [Accepted: 02/22/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVES We aimed to provide a consensus statement by the International Rapid Eye Movement Sleep Behavior Disorder Study Group (IRBD-SG) on devising controlled active treatment studies in rapid eye movement sleep behavior disorder (RBD) and devising studies of neuroprotection against Parkinson disease (PD) and related neurodegeneration in RBD. METHODS The consensus statement was generated during the fourth IRBD-SG symposium in Marburg, Germany in 2011. The IRBD-SG identified essential methodologic components for a randomized trial in RBD, including potential screening and diagnostic criteria, inclusion and exclusion criteria, primary and secondary outcomes for symptomatic therapy trials (particularly for melatonin and clonazepam), and potential primary and secondary outcomes for eventual trials with disease-modifying and neuroprotective agents. The latter trials are considered urgent, given the high conversion rate from idiopathic RBD (iRBD) to Parkinsonian disorders (i.e., PD, dementia with Lewy bodies [DLB], multiple system atrophy [MSA]). RESULTS Six inclusion criteria were identified for symptomatic therapy and neuroprotective trials: (1) diagnosis of RBD needs to satisfy the International Classification of Sleep Disorders, second edition, (ICSD-2) criteria; (2) minimum frequency of RBD episodes should preferably be ⩾2 times weekly to allow for assessment of change; (3) if the PD-RBD target population is included, it should be in the early stages of PD defined as Hoehn and Yahr stages 1-3 in Off (untreated); (4) iRBD patients with soft neurologic dysfunction and with operational criteria established by the consensus of study investigators; (5) patients with mild cognitive impairment (MCI); and (6) optimally treated comorbid OSA. Twenty-four exclusion criteria were identified. The primary outcome measure for RBD treatment trials was determined to be the Clinical Global Impression (CGI) efficacy index, consisting of a four-point scale with a four-point side-effect scale. Assessment of video-polysomnographic (vPSG) changes holds promise but is costly and needs further elaboration. Secondary outcome measures include sleep diaries; sleepiness scales; PD sleep scale 2 (PDSS-2); serial motor examinations; cognitive indices; mood and anxiety indices; assessment of frequency of falls, gait impairment, and apathy; fatigue severity scale; and actigraphy and customized bed alarm systems. Consensus also was established for evaluating the clinical and vPSG aspects of RBD. End points for neuroprotective trials in RBD, taking lessons from research in PD, should be focused on the ultimate goal of determining the performance of disease-modifying agents. To date no compound with convincing evidence of disease-modifying or neuroprotective efficacy has been identified in PD. Nevertheless, iRBD patients are considered ideal candidates for neuroprotective studies. CONCLUSIONS The IRBD-SG provides an important platform for developing multinational collaborative studies on RBD such as on environmental risk factors for iRBD, as recently reported in a peer-reviewed journal article, and on controlled active treatment studies for symptomatic and neuroprotective therapy that emerged during the 2011 consensus conference in Marburg, Germany, as described in our report.
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Affiliation(s)
- C H Schenck
- Minnesota Regional Sleep Disorders Center, Department of Psychiatry, Hennepin County Medical Center and University of Minnesota Medical School, Minneapolis, MN, USA.
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Martinez-Martin P, Chaudhuri KR, Rojo-Abuin JM, Rodriguez-Blazquez C, Alvarez-Sanchez M, Arakaki T, Bergareche-Yarza A, Chade A, Garretto N, Gershanik O, Kurtis MM, Martinez-Castrillo JC, Mendoza-Rodriguez A, Moore HP, Rodriguez-Violante M, Singer C, Tilley BC, Huang J, Stebbins GT, Goetz CG. Assessing the non-motor symptoms of Parkinson's disease: MDS-UPDRS and NMS Scale. Eur J Neurol 2013; 22:37-43. [PMID: 23607783 DOI: 10.1111/ene.12165] [Citation(s) in RCA: 70] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2012] [Accepted: 02/28/2013] [Indexed: 11/27/2022]
Abstract
BACKGROUND AND PURPOSE Although Parkinson's disease (PD) is characterized by typical motor manifestations, non-motor symptoms (NMS) are an outstanding part of the disease. At present, several specific instruments for assessment of NMS are available. The objective of our study was to determine the performance of the Movement Disorder Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS): Part I - Non-Motor Aspects of Experiences of Daily Living (nM-EDL) compared with the Non-Motor Symptoms Scale (NMSS). METHODS To this purpose, 434 consecutive patients with PD were included in an international, observational, cross-sectional study. The association between scores of both scales was determined by the Spearman rank correlation coefficient. Equations for transformation of total score of a scale to the other were constructed from weighted regression models and both, transformed and observed score, contrasted by means of the Lin's Concordance Correlation Coefficient (LCCC) and Bland-Altman plot. RESULTS As a whole, the prevalence of the NMS according to each scale was quite similar, and most of the correlations between their corresponding components were high (r(S) > 0.60). The total score correlation of the MDS-UPDRS Part I with the NMSS was high (r(S) = 0.81). Concerning the transformed scores, estimated scores only partially approach the observed ones (sharing about 60-64% of the variance) because residual variance increased with increasing magnitudes of the scores, i.e. the most severe patients (Bland-Altman plot; LCCC < 0.60 for severe patients). CONCLUSIONS (i) MDS-UPDRS Part I (nM-EDL) and NMSS showed a strong convergent validity; (ii) however, transformed scores using the equations from weighted regression models showed that for patients with the most severe NMS they are not concordant.
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Affiliation(s)
- P Martinez-Martin
- Alzheimer Center Reina Sofia Foundation and CIBERNED, Carlos III Institute of Health, Madrid, Spain
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