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Feil L, Senz J, Ta M, Huvila J, Greif K, Krämer B, Brucker S, Grimm C, Bartl T, Zeder-Gösz C, Schmöckel E, Trillsch F, Mahner S, Kommoss F, Lehr HA, Wiedemeyer K, Köbel M, Staebler A, Anglesio M, Kommoss S. Molecular stratification of clear cell ovarian carcinomas. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1718135] [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: 10/23/2022] Open
Affiliation(s)
| | - J Senz
- University of British Columbia, OVCARE/Dep. of Obstetrics and Gynecology
| | - M Ta
- University of British Columbia, OVCARE/Dep. of Obstetrics and Gynecology
| | - J Huvila
- University of British Columbia, OVCARE/Dep. of Obstetrics and Gynecology
| | - K Greif
- Institut für Pathologie und Neuropathologie, Abteilung Allgemeine Pathologie und Pathologische Anatomie
| | | | | | - C Grimm
- Universitätsklinik für Frauenheilkunde, Abteilung für allgemeine Gynäkologie und gynäkologische Onkologie
| | - T Bartl
- Universitätsklinik für Frauenheilkunde, Abteilung für allgemeine Gynäkologie und gynäkologische Onkologie
| | - C Zeder-Gösz
- Klinikum der Universität München, Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe
| | - E Schmöckel
- Pathologisches Institut der Ludwig-Maximilians-Universität
| | - F Trillsch
- Klinikum der Universität München, Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe
| | - S Mahner
- Klinikum der Universität München, Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe
| | - F Kommoss
- Institut für Pathologie im Medizin Campus Bodensee
| | - H.-A Lehr
- Institut für Pathologie im Medizin Campus Bodensee
| | - K Wiedemeyer
- Department of Pathology and Laboratory Medicine, University of Calgary
| | - M Köbel
- Department of Pathology and Laboratory Medicine, University of Calgary
| | - A Staebler
- Institut für Pathologie und Neuropathologie, Abteilung Allgemeine Pathologie und Pathologische Anatomie
| | - M Anglesio
- University of British Columbia, OVCARE/Dep. of Obstetrics and Gynecology
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Heitz F, Krämer P, Talhouk A, MA B, DS C, ES C, Scheunhage D, RF H, Senz J, Leung S, Hartkopf A, Krämer B, Brucker S, du Bois A, Harter P, FK K, Heublein S, Kommoss F, JN M, Singh N, Bosse T, Köbel M, MS A, Staebler A, Kommoss S. Anwendung der molekularen Risikostratifikation des Endometriums auf das endometrioide Ovarialkarzinom- eine retrospektive, internationale Multizenterstudie. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1718219] [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: 10/23/2022] Open
Affiliation(s)
- F Heitz
- Kliniken Essen-Mitte, Klinik für Gynäkologie und gynäkologische Onkologie
| | - P Krämer
- Tuebingen University Hospital, Department of Women’s Health
- University of British Columbia, Department of Obstetrics and Gynecology
| | - A Talhouk
- University of British Columbia, Department of Obstetrics and Gynecology
- BC Cancer, Vancouver General Hospital, and University of British Columbia, British Columbia’s Gynecological Cancer Research Team (OVCARE)
| | - Brett MA
- McMaster University, Department of Pathology and Molecular Medicine
| | - Chiu DS
- BC Cancer, Vancouver General Hospital, and University of British Columbia, British Columbia’s Gynecological Cancer Research Team (OVCARE)
- BC Cancer Research Centre, Department of Molecular Oncology
| | - Cairns ES
- University of British Columbia, Department of Obstetrics and Gynecology
| | - D Scheunhage
- Leiden University Medical Centre (LUMC), Department of Pathology
| | - Hammond RF
- Barts Health National Health Service Trust, Department of Pathology
| | - J Senz
- BC Cancer, Vancouver General Hospital, and University of British Columbia, British Columbia’s Gynecological Cancer Research Team (OVCARE)
- University of British Columbia, Department of Pathology and Laboratory Medicine
| | - S Leung
- BC Cancer, Vancouver General Hospital, and University of British Columbia, British Columbia’s Gynecological Cancer Research Team (OVCARE)
- University of British Columbia, Department of Pathology and Laboratory Medicine
| | - A Hartkopf
- Tuebingen University Hospital, Department of Women’s Health
| | - B Krämer
- Tuebingen University Hospital, Department of Women’s Health
| | - S Brucker
- Tuebingen University Hospital, Department of Women’s Health
| | - A du Bois
- Kliniken Essen-Mitte, Klinik für Gynäkologie und gynäkologische Onkologie
| | - P Harter
- Kliniken Essen-Mitte, Klinik für Gynäkologie und gynäkologische Onkologie
| | - Kommoss FK
- Heidelberg University Hospital, Institute of Pathology
| | - S Heublein
- Heidelberg University Hospital, Heidelberg and National Center for Tumor Diseases, Department of Obstetrics and Gynecology
| | - F Kommoss
- Medizin Campus Bodensee, Institute of Pathology
| | - McAlpine JN
- University of British Columbia, Department of Obstetrics and Gynecology
- BC Cancer Research Centre, Department of Molecular Oncology
| | - N Singh
- Barts Health National Health Service Trust, Department of Pathology
| | - T Bosse
- Leiden University Medical Centre (LUMC), Department of Pathology
| | - M Köbel
- Department of Pathology and Laboratory Medicine, University of Calgary
| | - Anglesio MS
- University of British Columbia, Department of Obstetrics and Gynecology
- BC Cancer, Vancouver General Hospital, and University of British Columbia, British Columbia’s Gynecological Cancer Research Team (OVCARE)
| | - A Staebler
- University Hospital Tuebingen, Institute of Pathology and Neuropathology
| | - S Kommoss
- Tuebingen University Hospital, Department of Women’s Health
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Kommoss S, McConechy MK, Kommoss F, Leung S, Bunz A, Magrill J, Britton H, Kommoss F, Grevenkamp F, Karnezis A, Yang W, Lum A, Krämer B, Taran F, Staebler A, Lax S, Brucker SY, Huntsman DG, Gilks CB, McAlpine JN, Talhouk A. Final validation of the ProMisE molecular classifier for endometrial carcinoma in a large population-based case series. Ann Oncol 2019; 29:1180-1188. [PMID: 29432521 DOI: 10.1093/annonc/mdy058] [Citation(s) in RCA: 375] [Impact Index Per Article: 75.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Background We have previously developed and confirmed a pragmatic molecular classifier for endometrial cancers; ProMisE (Proactive Molecular Risk Classifier for Endometrial Cancer). Inspired by the Cancer Genome Atlas, ProMisE identifies four prognostically distinct molecular subtypes and can be applied to diagnostic specimens (biopsy/curettings) enabling earlier informed decision-making. We have strictly adhered to the Institute of Medicine (IOM) guidelines for the development of genomic biomarkers, and herein present the final validation step of a locked-down classifier before clinical application. Patients and methods We assessed a retrospective cohort of women from the Tübingen University Women's Hospital treated for endometrial carcinoma between 2003 and 2013. Primary outcomes of overall, disease-specific, and progression-free survival were evaluated for clinical, pathological, and molecular features. Results Complete clinical and molecular data were evaluable from 452 women. Patient age ranged from 29 to 93 (median 65) years, and 87.8% cases were endometrioid histotype. Grade distribution included 282 (62.4%) G1, 75 (16.6%) G2, and 95 (21.0%) G3 tumors. 276 (61.1%) patients had stage IA disease, with the remaining stage IB [89 (19.7%)], stage II [26 (5.8%)], and stage III/IV [61 (13.5%)]. ProMisE molecular classification yielded 127 (28.1%) MMR-D, 42 (9.3%) POLE, 55 (12.2%) p53abn, and 228 (50.4%) p53wt. ProMisE was a prognostic marker for progression-free (P = 0.001) and disease-specific (P = 0.03) survival even after adjusting for known risk factors. Concordance between diagnostic and surgical specimens was highly favorable; accuracy 0.91, κ 0.88. Discussion We have developed, confirmed, and now validated a pragmatic molecular classification tool (ProMisE) that provides consistent categorization of tumors and identifies four distinct prognostic molecular subtypes. ProMisE can be applied to diagnostic samples and thus could be used to inform surgical procedure(s) and/or need for adjuvant therapy. Based on the IOM guidelines this classifier is now ready for clinical evaluation through prospective clinical trials.
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Affiliation(s)
- S Kommoss
- Department of Women's Health, Tübingen University Hospital, Tübingen, Germany
| | - M K McConechy
- Department of Human Genetics, Research Institute of the McGill University Health Network, McGill University, Montreal, Canada
| | - F Kommoss
- Institute of Pathology, Im Medizin Campus Bodensee, Friedrichshafen, Germany
| | - S Leung
- Genetic Pathology Evaluation Center, Vancouver
| | - A Bunz
- Department of Women's Health, Tübingen University Hospital, Tübingen, Germany
| | - J Magrill
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada
| | - H Britton
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada
| | - F Kommoss
- Department of Women's Health, Tübingen University Hospital, Tübingen, Germany; Institute of Pathology, Heidelberg University, Heidelberg
| | - F Grevenkamp
- Department of Women's Health, Tübingen University Hospital, Tübingen, Germany
| | - A Karnezis
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada
| | - W Yang
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada
| | - A Lum
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada
| | - B Krämer
- Department of Women's Health, Tübingen University Hospital, Tübingen, Germany
| | - F Taran
- Department of Women's Health, Tübingen University Hospital, Tübingen, Germany
| | - A Staebler
- Institute of Pathology, Tübingen University Hospital, Tübingen, Germany
| | - S Lax
- Institute of Pathology, LKH Graz West, Graz, Austria
| | - S Y Brucker
- Department of Women's Health, Tübingen University Hospital, Tübingen, Germany
| | - D G Huntsman
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada
| | - C B Gilks
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada
| | - J N McAlpine
- Department of Gynecology and Obstetrics, Division of Gynecologic Oncology, University of British Columbia, Vancouver.
| | - A Talhouk
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada
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Lac V, Verhoef L, Aguirre-Hernandez R, Nazeran TM, Tessier-Cloutier B, Praetorius T, Orr NL, Noga H, Lum A, Khattra J, Prentice LM, Co D, Köbel M, Mijatovic V, Lee AF, Pasternak J, Bleeker MC, Krämer B, Brucker SY, Kommoss F, Kommoss S, Horlings HM, Yong PJ, Huntsman DG, Anglesio MS. Iatrogenic endometriosis harbors somatic cancer-driver mutations. Hum Reprod 2019; 34:69-78. [PMID: 30428062 DOI: 10.1093/humrep/dey332] [Citation(s) in RCA: 58] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Accepted: 11/01/2018] [Indexed: 12/17/2022] Open
Abstract
STUDY QUESTION Does incisional endometriosis (IE) harbor somatic cancer-driver mutations? SUMMARY ANSWER We found that approximately one-quarter of IE cases harbor somatic-cancer mutations, which commonly affect components of the MAPK/RAS or PI3K-Akt-mTor signaling pathways. WHAT IS KNOWN ALREADY Despite the classification of endometriosis as a benign gynecological disease, it shares key features with cancers such as resistance to apoptosis and stimulation of angiogenesis and is well-established as the precursor of clear cell and endometrioid ovarian carcinomas. Our group has recently shown that deep infiltrating endometriosis (DE), a form of endometriosis that rarely undergoes malignant transformation, harbors recurrent somatic mutations. STUDY DESIGN, SIZE, DURATION In a retrospective study comparing iatrogenically induced and endogenously occurring forms of endometriosis unlikely to progress to cancer, we examined endometriosis specimens from 40 women with IE and 36 women with DE. Specimens were collected between 2004 and 2017 from five hospital sites in either Canada, Germany or the Netherlands. IE and DE cohorts were age-matched and all women presented with histologically typical endometriosis without known history of malignancy. PARTICIPANTS/MATERIALS, SETTING, METHODS Archival tissue specimens containing endometriotic lesions were macrodissected and/or laser-capture microdissected to enrich endometriotic stroma and epithelium and a hypersensitive cancer hotspot sequencing panel was used to assess for presence of somatic mutations. Mutations were subsequently validated using droplet digital PCR. PTEN and ARID1A immunohistochemistry (IHC) were performed as surrogates for somatic events resulting in functional loss of respective proteins. MAIN RESULTS AND THE ROLE OF CHANCE Overall, we detected somatic cancer-driver events in 11 of 40 (27.5%) IE cases and 13 of 36 (36.1%) DE cases, including hotspot mutations in KRAS, ERBB2, PIK3CA and CTNNB1. Heterogeneous PTEN loss occurred at similar rates in IE and DE (7/40 vs 5/36, respectively), whereas ARID1A loss only occurred in a single case of DE. While rates of detectable somatic cancer-driver events between IE and DE are not statistically significant (P > 0.05), KRAS activating mutations were more prevalent in DE. LIMITATIONS, REASONS FOR CAUTION Detection of somatic cancer-driver events were limited to hotspots analyzed in our panel-based sequencing assay and loss of protein expression by IHC from archival tissue. Whole genome or exome sequencing, or epigenetic analysis may uncover additional somatic alterations. Moreover, because of the descriptive nature of this study, the functional roles of identified mutations within the context of endometriosis remain unclear and causality cannot be established. WIDER IMPLICATIONS OF THE FINDINGS The alterations we report may be important in driving the growth and survival of endometriosis in ectopic regions of the body. Given the frequency of mutation in surgically displaced endometrium (IE), examination of similar somatic events in eutopic endometrium, as well as clinically annotated cases of other forms of endometriosis, in particular endometriomas that are most commonly linked to malignancy, is warranted. STUDY FUNDING/COMPETING INTEREST(S) This study was funded by a Canadian Cancer Society Impact Grant [701603, PI Huntsman], Canadian Institutes of Health Research Transitional Open Operating Grant [MOP-142273, PI Yong], the Canadian Institutes of Health Research Foundation Grant [FDN-154290, PI Huntsman], the Canadian Institutes of Health Research Project Grant [PJT-156084, PIs Yong and Anglesio], and the Janet D. Cottrelle Foundation through the BC Cancer Foundation [PI Huntsman]. D.G. Huntsman is a co-founder and shareholder of Contextual Genomics Inc., a for profit company that provides clinical reporting to assist in cancer patient treatment. R. Aguirre-Hernandez, J. Khattra and L.M. Prentice have a patent MOLECULAR QUALITY ASSURANCE METHODS FOR USE IN SEQUENCING pending and are current (or former) employees of Contextual Genomics Inc. The remaining authors have no competing interests to declare. TRIAL REGISTRATION NUMBER Not applicable.
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Affiliation(s)
- V Lac
- Department of Molecular Oncology, BC Cancer Research Centre, Room 3-218, 675 West 10th Ave, Vancouver, British Columbia, Canada.,Department of Pathology and Laboratory Medicine, Rm G227, 2211 Wesbrook Mall, University of British Columbia, Vancouver, British Columbia, Canada
| | - L Verhoef
- Department of Pathology of Antoni van Leeuwenhoek, Netherlands Cancer Institute, Plesmanlaan 121, CX Amsterdam, The Netherlands
| | - R Aguirre-Hernandez
- Contextual Genomics, 2389 Health Sciences Mall #204, Vancouver, British Columbia, Canada
| | - T M Nazeran
- Department of Molecular Oncology, BC Cancer Research Centre, Room 3-218, 675 West 10th Ave, Vancouver, British Columbia, Canada.,Department of Anatomical Pathology, Vancouver General Hospital, 899 W 12th Ave, Vancouver, British Columbia, Canada
| | - B Tessier-Cloutier
- Department of Pathology and Laboratory Medicine, Rm G227, 2211 Wesbrook Mall, University of British Columbia, Vancouver, British Columbia, Canada.,Department of Anatomical Pathology, Vancouver General Hospital, 899 W 12th Ave, Vancouver, British Columbia, Canada
| | - T Praetorius
- Department of Molecular Oncology, BC Cancer Research Centre, Room 3-218, 675 West 10th Ave, Vancouver, British Columbia, Canada.,Department of Women's Health, Tuebingen University Hospital, Calwerstrasse 7, Tuebingen, Germany
| | - N L Orr
- Department of Obstetrics and Gynaecology, University of British Columbia, Suite 930, 1125 Howe Street, Vancouver, British Columbia, Canada.,BC Women's Centre for Pelvic Pain & Endometriosis, BC Women's Hospital and Health Centre, Women' Health Centre, F2-4500 Oak St, Vancouver, British Columbia, Canada
| | - H Noga
- Department of Obstetrics and Gynaecology, University of British Columbia, Suite 930, 1125 Howe Street, Vancouver, British Columbia, Canada.,BC Women's Centre for Pelvic Pain & Endometriosis, BC Women's Hospital and Health Centre, Women' Health Centre, F2-4500 Oak St, Vancouver, British Columbia, Canada
| | - A Lum
- Department of Molecular Oncology, BC Cancer Research Centre, Room 3-218, 675 West 10th Ave, Vancouver, British Columbia, Canada
| | - J Khattra
- Contextual Genomics, 2389 Health Sciences Mall #204, Vancouver, British Columbia, Canada
| | - L M Prentice
- Contextual Genomics, 2389 Health Sciences Mall #204, Vancouver, British Columbia, Canada
| | - D Co
- Department of Molecular Oncology, BC Cancer Research Centre, Room 3-218, 675 West 10th Ave, Vancouver, British Columbia, Canada
| | - M Köbel
- Department of Pathology and Laboratory Medicine, University of Calgary, 2500 University Dr NW, Calgary, Alberta, Canada
| | - V Mijatovic
- Academic Endometriosis Center VUmc, Department of Reproductive Medicine, VU University Medical Center, De Boelelaan 1117, HV Amsterdam, The Netherlands
| | - A F Lee
- Department of Pathology and Laboratory Medicine, Rm G227, 2211 Wesbrook Mall, University of British Columbia, Vancouver, British Columbia, Canada
| | - J Pasternak
- Department of Women's Health, Tuebingen University Hospital, Calwerstrasse 7, Tuebingen, Germany
| | - M C Bleeker
- Academic Endometriosis Center VUmc, Department of Reproductive Medicine, VU University Medical Center, De Boelelaan 1117, HV Amsterdam, The Netherlands
| | - B Krämer
- Department of Women's Health, Tuebingen University Hospital, Calwerstrasse 7, Tuebingen, Germany
| | - S Y Brucker
- Department of Women's Health, Tuebingen University Hospital, Calwerstrasse 7, Tuebingen, Germany
| | - F Kommoss
- Institute of Pathology, Medizin Campus Bodensee, Roentgenstrasse 2, Friedrichshafen, Germany
| | - S Kommoss
- Department of Women's Health, Tuebingen University Hospital, Calwerstrasse 7, Tuebingen, Germany
| | - H M Horlings
- Department of Pathology of Antoni van Leeuwenhoek, Netherlands Cancer Institute, Plesmanlaan 121, CX Amsterdam, The Netherlands
| | - P J Yong
- Department of Obstetrics and Gynaecology, University of British Columbia, Suite 930, 1125 Howe Street, Vancouver, British Columbia, Canada.,BC Women's Centre for Pelvic Pain & Endometriosis, BC Women's Hospital and Health Centre, Women' Health Centre, F2-4500 Oak St, Vancouver, British Columbia, Canada
| | - D G Huntsman
- Department of Molecular Oncology, BC Cancer Research Centre, Room 3-218, 675 West 10th Ave, Vancouver, British Columbia, Canada.,Department of Pathology and Laboratory Medicine, Rm G227, 2211 Wesbrook Mall, University of British Columbia, Vancouver, British Columbia, Canada.,Department of Anatomical Pathology, Vancouver General Hospital, 899 W 12th Ave, Vancouver, British Columbia, Canada.,Department of Obstetrics and Gynaecology, University of British Columbia, Suite 930, 1125 Howe Street, Vancouver, British Columbia, Canada
| | - M S Anglesio
- Department of Molecular Oncology, BC Cancer Research Centre, Room 3-218, 675 West 10th Ave, Vancouver, British Columbia, Canada.,Department of Pathology and Laboratory Medicine, Rm G227, 2211 Wesbrook Mall, University of British Columbia, Vancouver, British Columbia, Canada.,Department of Obstetrics and Gynaecology, University of British Columbia, Suite 930, 1125 Howe Street, Vancouver, British Columbia, Canada
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6
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Kommoss S, Heitz F, Winterhoff BJN, Wang C, Sehouli J, Aliferis C, Kimmig R, Wang J, Ma S, de Gregorio N, Mahner S, du Bois A, Tourani R, Park-Simon TW, Baumann K, Taran FA, Kommoss F, Schroeder W, Dowdy SC, Pfisterer J. Significant Overall Survival Improvement In Proliferative Subtype Ovarian Cancer Patients Receiving Bevacizumab. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1675442] [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: 10/27/2022] Open
Affiliation(s)
- S Kommoss
- Department of Women's Health, Tuebingen University Hospital, Tuebingen, Germany
| | - F Heitz
- Department of Gynecologic Oncology, Kliniken Essen-Mitte, Essen, Germany
| | - BJN Winterhoff
- Division of Gynecologic Oncology, University of Minnesota, Minneapolis, MN
| | - C Wang
- Mayo Clinic, Rochester, MN
| | - J Sehouli
- AGO and Charité Campus Virchow-Klinikum, Berlin, Germany
| | - C Aliferis
- Institute for Health Informatics (IHI), Academic Health Center, University of Minnesota, Minneapolis, MN
| | - R Kimmig
- Department of Gynecology and Obstetrics, University of Duisburg-Essen, Essen, Germany
| | - J Wang
- Institute for Health Informatics (IHI), Academic Health Center, University of Minnesota, Minneapolis, MN
| | - S Ma
- Institute for Health Informatics (IHI), Academic Health Center, University of Minnesota, Minneapolis, MN
| | - N de Gregorio
- Department of Obstrics and Gynecology, Universtity of Ulm, Ulm, Germany
| | - S Mahner
- Ludwig-Maximilians-Universität München and University Medical Center Hamburg-Eppendorf, Germany, Munich, Germany
| | - A du Bois
- Department of Gynecologic Oncology, Kliniken Essen-Mitte, Essen, Germany
| | - R Tourani
- Institute for Health Informatics (IHI), Academic Health Center, University of Minnesota, Minneapolis, MN
| | | | - K Baumann
- Klinikum der Stadt Ludwigshafen am Rhein gGmbH, Ludwigshafen, Germany
| | - FA Taran
- Department of Women's Health, Tuebingen University Hospital, Tuebingen, Germany
| | - F Kommoss
- Institut für Pathologie im Medizin Campus Bodensee, Friedrichshafen, Germany
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7
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Lac V, Praetorius TH, Verhoef L, Aguirre-Hernandez R, Nazeran TM, Tessier-Cloutier B, Orr N, Noga H, Khattra J, Koebel M, Horlings HM, Kommoss F, Brucker SY, Pasternak J, Yong PJ, Huntsman DG, Kommoss S, Anglesio MS, Krämer B. Iatrogenic endometriosis harbors somatic cancer-driver mutations. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671405] [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: 10/28/2022] Open
Affiliation(s)
- V Lac
- British Columbia Cancer Agency, Department of Molecular Oncology, Vancouver, Kanada
- University of British Columbia, Department of Pathology and Laboratory Medicine, Vancouver, Kanada
| | - TH Praetorius
- Universitätsklinikum Tübingen, Department für Frauengesundheit, Tübingen, Deutschland
- University of British Columbia, Department of Obstetrics and Gynecology, Vancouver, Kanada
| | - L Verhoef
- Netherlands Cancer Institute, Amsterdam, Niederlande
| | | | - TM Nazeran
- British Columbia Cancer Agency, Department of Molecular Oncology, Vancouver, Kanada
- University of British Columbia, Department of Pathology and Laboratory Medicine, Vancouver, Kanada
| | - B Tessier-Cloutier
- University of British Columbia, Department of Pathology and Laboratory Medicine, Vancouver, Kanada
- Vancouver General Hospital, Department of Anatomical Pathology, Vancouver, Kanada
| | - N Orr
- University of British Columbia, Department of Obstetrics and Gynecology, Vancouver, Kanada
| | - H Noga
- University of British Columbia, Department of Obstetrics and Gynecology, Vancouver, Kanada
- British Columbia Women's Hospital and Health Centre, BC Women's Centre for Pelvic Pain & Endometriosis, Vancouver, Kanada
| | - J Khattra
- Contextual Genomics, Vancouver, Kanada
| | - M Koebel
- University of Calgary, Department of Pathology and Laboratory Medicine, Calgary, Kanada
| | - HM Horlings
- Netherlands Cancer Institute, Amsterdam, Niederlande
| | - F Kommoss
- Medizin Campus Bodensee, Institut für Pathologie, Friedrichshafen, Deutschland
| | - SY Brucker
- Universitätsklinikum Tübingen, Department für Frauengesundheit, Tübingen, Deutschland
| | - J Pasternak
- Universitätsklinikum Tübingen, Department für Frauengesundheit, Tübingen, Deutschland
| | - PJ Yong
- University of British Columbia, Department of Obstetrics and Gynecology, Vancouver, Kanada
- British Columbia Women's Hospital and Health Centre, BC Women's Centre for Pelvic Pain & Endometriosis, Vancouver, Kanada
| | - DG Huntsman
- British Columbia Cancer Agency, Department of Molecular Oncology, Vancouver, Kanada
- University of British Columbia, Department of Pathology and Laboratory Medicine, Vancouver, Kanada
- Contextual Genomics, Vancouver, Kanada
| | - S Kommoss
- Universitätsklinikum Tübingen, Department für Frauengesundheit, Tübingen, Deutschland
| | - MS Anglesio
- University of British Columbia, Department of Pathology and Laboratory Medicine, Vancouver, Kanada
- University of British Columbia, Department of Obstetrics and Gynecology, Vancouver, Kanada
| | - B Krämer
- Universitätsklinikum Tübingen, Department für Frauengesundheit, Tübingen, Deutschland
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Kommoss S, Heitz F, Winterhoff B, Wang C, Canzler U, Aliferis C, Belau A, Wang J, Hanker L, Kommoss F, du Bois A, Ma S, Sehouli J, Kimmig R, Tourani R, Kurzeder C, Mahner S, Park-Simon TW, Dowdy SC, Pfisterer J. Significant overall survival improvement in proliferative subtype ovarian cancer patients receiving bevacizumab. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671332] [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: 10/28/2022] Open
Affiliation(s)
- S Kommoss
- Department für Frauengesundheit, Universitätsklinikum Tübingen, Tübingen, Deutschland
| | - F Heitz
- Kliniken Essen-Mitte (KEM), Gynäkologie und Gynäkologische Onkologie, Essen, Deutschland
| | - B Winterhoff
- University of Minnesota, Division of Gynecologic Oncology, Minneapolis, Vereinigte Staaten von Amerika
| | - C Wang
- Mayo Clinic, Rochester, Vereinigte Staaten von Amerika
| | - U Canzler
- Uni.-Klinikum Carl Gustav Carus, Dresden, Deutschland
| | - C Aliferis
- Academic Health Center, University of Minnesota, Institute for Health Informatics (IHI), Minneapolis, Vereinigte Staaten von Amerika
| | - A Belau
- Universitätsmedizin Greifswald, Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe, Greifswald, Deutschland
| | - J Wang
- Academic Health Center, University of Minnesota, Institute for Health Informatics (IHI), Minneapolis, Vereinigte Staaten von Amerika
| | - L Hanker
- Universitätsklinikum Schleswig-Holstein Campus Lübeck, Klinik für Frauenheilkunde und Geburtshilfe, Lübeck, Deutschland
| | - F Kommoss
- Institut für Pathologie im Medizin Campus Bodensee Friedrichshafen, Friedrichshafen, Deutschland
| | - A du Bois
- Kliniken Essen-Mitte (KEM), Gynäkologie und Gynäkologische Onkologie, Essen, Deutschland
| | - S Ma
- Academic Health Center, University of Minnesota, Institute for Health Informatics (IHI), Minneapolis, Vereinigte Staaten von Amerika
| | - J Sehouli
- Universitätsmedizin Berlin Charité, Campus Virchow Klinikum, Klinik für Frauenheilkunde, Berlin, Deutschland
| | - R Kimmig
- Universitätsklinikum Essen, Frauenklinik, Essen, Deutschland
| | - R Tourani
- Academic Health Center, University of Minnesota, Institute for Health Informatics (IHI), Minneapolis, Vereinigte Staaten von Amerika
| | - C Kurzeder
- Universitätsspital Basel, Frauenklinik, Basel, Schweiz
| | - S Mahner
- Klinikum der Ludwig-Maximilians-Universität München, Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe, München, Deutschland
| | - TW Park-Simon
- Medizinische Hochschule Hannover, Gynäkologische Onkologie, Hannover, Deutschland
| | - SC Dowdy
- Mayo Clinic, Rochester, Vereinigte Staaten von Amerika
| | - J Pfisterer
- Zentrum für Gynäkologische Onkologie Kiel, Kiel, Deutschland
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Wagner P, Kommoss F, Kommoss S, Hartkopf AD, Pasternak I, Oberlechner E, Wallwiener M, Neis F, Abele H, Krämer B, Reisenauer C, Staebler A, Wallwiener D, Brucker SY, Taran FA. Unexpected malignant uterine pathology: incidence, characteristics and outcome in a large single-center series of hysterectomies for presumed benign uterine disease. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671601] [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: 10/28/2022] Open
Affiliation(s)
- P Wagner
- University of Tübingen, Department of Obstetrics and Gynecology, Tübingen, Deutschland
| | - F Kommoss
- University of Heidelberg, Institute of Pathology, Heidelberg, Deutschland
| | - S Kommoss
- University of Tübingen, Department of Obstetrics and Gynecology, Tübingen, Deutschland
| | - AD Hartkopf
- University of Tübingen, Department of Obstetrics and Gynecology, Tübingen, Deutschland
| | - I Pasternak
- University of Tübingen, Department of Obstetrics and Gynecology, Tübingen, Deutschland
| | - E Oberlechner
- University of Tübingen, Department of Obstetrics and Gynecology, Tübingen, Deutschland
| | - M Wallwiener
- University of Heidelberg, Department of Obstetrics and Gynecology, Heidelberg, Deutschland
| | - F Neis
- University of Tübingen, Department of Obstetrics and Gynecology, Tübingen, Deutschland
| | - H Abele
- University of Tübingen, Department of Obstetrics and Gynecology, Tübingen, Deutschland
| | - B Krämer
- University of Tübingen, Department of Obstetrics and Gynecology, Tübingen, Deutschland
| | - C Reisenauer
- University of Tübingen, Department of Obstetrics and Gynecology, Tübingen, Deutschland
| | - A Staebler
- University of Tübingen, Institute of Pathology, Tübingen, Deutschland
| | - D Wallwiener
- University of Tübingen, Department of Obstetrics and Gynecology, Tübingen, Deutschland
| | - SY Brucker
- University of Tübingen, Department of Obstetrics and Gynecology, Tübingen, Deutschland
| | - FA Taran
- University of Tübingen, Department of Obstetrics and Gynecology, Tübingen, Deutschland
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Keul J, Kommoss F, Karnezis AN, Wang Y, Pasternak J, Hartkopf A, Oberlechner E, Taran A, Staebler A, Schmidt D, Gilks CB, Huntsman DG, Brucker SY, Kommoss S. Sertoli-Leydigzelltumoren (SLCT) des Ovars: Dicer1- und Foxl2-Mutationsstatus als Beitrag zur Etablierung einer neuartigen, klinisch und histopathologisch relevanten Klassifikation. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671047] [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: 10/28/2022] Open
Affiliation(s)
- J Keul
- Universitätsfrauenklinik Tübingen, Tübingen, Deutschland
| | - F Kommoss
- Institut für Pathologie, Friedrichshafen, Deutschland
| | - AN Karnezis
- BC Cancer Research Centre, Vancouver, Kanada
| | - Y Wang
- BC Cancer Research Centre, Vancouver, Kanada
| | - J Pasternak
- Universitätsfrauenklinik Tübingen, Tübingen, Deutschland
| | - A Hartkopf
- Universitätsfrauenklinik Tübingen, Tübingen, Deutschland
| | - E Oberlechner
- Universitätsfrauenklinik Tübingen, Tübingen, Deutschland
| | - A Taran
- Universitätsfrauenklinik Tübingen, Tübingen, Deutschland
| | - A Staebler
- Institut für Pathologie, Tübingen, Deutschland
| | - D Schmidt
- Institut für Pathologie, Viersen, Deutschland
| | - CB Gilks
- BC Cancer Research Centre, Vancouver, Kanada
| | - DG Huntsman
- BC Cancer Research Centre, Vancouver, Kanada
| | - SY Brucker
- Universitätsfrauenklinik Tübingen, Tübingen, Deutschland
| | - S Kommoss
- Universitätsfrauenklinik Tübingen, Tübingen, Deutschland
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11
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Kommoss F, Talhouk A, Kommoss F, Taran FA, Staebler A, Gilks B, Huntsman D, Krämer B, Brucker SY, McAlpine J, Kommoss S. L1CAM to further stratify endometrial carcinoma patients with nonspecific molecular risk profile. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671351] [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: 10/28/2022] Open
Affiliation(s)
- F Kommoss
- Institut für Pathologie, Universitätsklinikum Heidelberg, Allgemeine Pathologie und path. Anatomie, Heidelberg, Deutschland
| | - A Talhouk
- University of British Columbia, Department of Pathology and Laboratory Medicine, Vancouver, Kanada
| | - F Kommoss
- Institut für Pathologie im Medizin Campus Bodensee Friedrichshafen, Friedrichshafen, Deutschland
| | - FA Taran
- Department für Frauengesundheit, Universitätsklinikum Tübingen, Tübingen, Deutschland
| | - A Staebler
- Universitätsklinikum Tübingen, Institut für Pathologie, Tübingen, Deutschland
| | - B Gilks
- University of British Columbia, Department of Pathology and Laboratory Medicine, Vancouver, Kanada
| | - D Huntsman
- University of British Columbia, Department of Pathology and Laboratory Medicine, Vancouver, Kanada
| | - B Krämer
- Department für Frauengesundheit, Universitätsklinikum Tübingen, Tübingen, Deutschland
| | - SY Brucker
- Department für Frauengesundheit, Universitätsklinikum Tübingen, Tübingen, Deutschland
| | - J McAlpine
- University of British Columbia, Department of Gynecology and Obstetrics, Vancouver, Kanada
| | - S Kommoss
- Department für Frauengesundheit, Universitätsklinikum Tübingen, Tübingen, Deutschland
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12
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Keul J, Taran A, Kommoss F, Hartkopf A, Wallwiener D, Brucker S, Oberlechner E, Staebler A, Kommoss S. Maligne Keimzell- und Keimstrang-Stromatumoren des Ovars: Systematische Erfassung und Durchführung einer spezialisierten histopathologischen Zweitbegutachtung. Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1592678] [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: 10/20/2022] Open
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13
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Kommoss F, Grevenkamp F, Taran FA, Fend F, Brucker S, Wallwiener D, Schönfisch B, Lax S, Kommoss F, Staebler A, Kommoss S. L1CAM als wichtiger Prognosefaktor für Endometriumkarzinome mit niedrigem/intermediärem Risikoprofil. Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1592679] [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: 10/20/2022] Open
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14
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Staebler A, Pfisterer J, Diebold J, Lax SF, Schmidt D, Kommoss F, du Bois A, Kommoss S. Internet based second opinion pathology in a large chemotherapy trial for ovarian cancer – results of a standardized review process. Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1592680] [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: 10/20/2022] Open
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15
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Trillsch F, Mahner S, Vettorazzi E, Woelber L, Reuss A, Baumann K, Keyver-Paik MD, Canzler U, Wollschlaeger K, Forner D, Pfisterer J, Schroeder W, Muenstedt K, Richter B, Fotopoulou C, Schmalfeldt B, Burges A, Ewald-Riegler N, de Gregorio N, Hilpert F, Fehm T, Meier W, Hillemanns P, Hanker L, Hasenburg A, Strauss HG, Hellriegel M, Wimberger P, Kommoss S, Kommoss F, Hauptmann S, du Bois A. Surgical staging and prognosis in serous borderline ovarian tumours (BOT): a subanalysis of the AGO ROBOT study. Br J Cancer 2015; 112:660-6. [PMID: 25562434 PMCID: PMC4333495 DOI: 10.1038/bjc.2014.648] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2014] [Revised: 11/27/2014] [Accepted: 12/06/2014] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Incomplete surgical staging is a negative prognostic factor for patients with borderline ovarian tumours (BOT). However, little is known about the prognostic impact of each individual staging procedure. METHODS Clinical parameters of 950 patients with BOT (confirmed by central reference pathology) treated between 1998 and 2008 at 24 German AGO centres were analysed. In 559 patients with serous BOT and adequate ovarian surgery, further recommended staging procedures (omentectomy, peritoneal biopsies, cytology) were evaluated applying Cox regression models with respect to progression-free survival (PFS). RESULTS For patients with one missing staging procedure, the hazard ratio (HR) for recurrence was 1.25 (95%-CI 0.66-2.39; P=0.497). This risk increased with each additional procedure skipped reaching statistical significance in case of two (HR 1.95; 95%-CI 1.06-3.58; P=0.031) and three missing steps (HR 2.37; 95%-CI 1.22-4.64; P=0.011). The most crucial procedure was omentectomy which retained a statistically significant impact on PFS in multiple analysis (HR 1.91; 95%-CI 1.15-3.19; P=0.013) adjusting for previously established prognostic factors as FIGO stage, tumour residuals, and fertility preservation. CONCLUSION Individual surgical staging procedures contribute to the prognosis for patients with serous BOT. In this analysis, recurrence risk increased with each skipped surgical step. This should be considered when re-staging procedures following incomplete primary surgery are discussed.
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Affiliation(s)
- F Trillsch
- Universitaetsklinikum Hamburg-Eppendorf, Klinik und Poliklinik fuer Gynaekologie, Martinistr. 52, 20246 Hamburg, Germany
| | - S Mahner
- Universitaetsklinikum Hamburg-Eppendorf, Klinik und Poliklinik fuer Gynaekologie, Martinistr. 52, 20246 Hamburg, Germany
| | - E Vettorazzi
- Universitaetsklinikum Hamburg-Eppendorf, Institut fuer Medizinische Biometrie und Epidemiologie, Martinistr. 52, 20246 Hamburg, Germany
| | - L Woelber
- Universitaetsklinikum Hamburg-Eppendorf, Klinik und Poliklinik fuer Gynaekologie, Martinistr. 52, 20246 Hamburg, Germany
| | - A Reuss
- Philipps-Universitaet Marburg, Koordinierungszentrum fuer Klinische Studien, Karl-von-Frisch-Str. 4, 35043 Marburg, Germany
| | - K Baumann
- Universitaetsklinikum Giessen u. Marburg GmbH, Klinik fuer Gynaekologie, Gyn. Endokrinologie und Onkologie, Baldingerstr., 35043 Marburg, Germany
| | - M-D Keyver-Paik
- Rheinische Friedrich-Wilhelms-Universitaet, Universitaets-Frauenklinik, Sigmund-Freud-Str. 25, 53127 Bonn, Germany
| | - U Canzler
- Technische Universitaet Dresden, Klinik und Poliklinik fuer Frauenheilkunde und Geburtshilfe, Fetscherstr. 74, 01307 Dresden, Germany
| | - K Wollschlaeger
- Universitaetsklinikum Magdeburg, Universitaets-Frauenklinik, Gerhart-Hauptmann-Str. 35, 39108 Magdeburg, Germany
| | - D Forner
- Sana-Klinikum Remscheid, Klinik fuer Frauenheilkunde und Geburtsmedizin, Burger Strasse 211, 42859 Remscheid, Germany
| | - J Pfisterer
- 1] Staedtisches Klinikum Solingen gGmbH, Klinik fuer Gynaekologie und Geburtshilfe, Gotenstrasse 1, 42653 Solingen, Germany [2] Zentrum fuer Gynaekologische Onkologie, Herzog-Friedrich-Str. 21, 24103 Kiel, Germany
| | - W Schroeder
- GYNAEKOLOGICUM Bremen, Schwachhauser Heerstrasse 367, 28211 Bremen, Germany
| | - K Muenstedt
- Universitaetsklinikum Giessen, Zentrum fuer Frauenheilkunde und Geburtshilfe, Klinikstrasse 33, 35352 Giessen, Germany
| | - B Richter
- Elblandkliniken Meissen-Radebeul GmbH & Co. KG, Frauenklinik, Heinrich-Zille-Str. 13, 01445 Radebeul, Germany
| | - C Fotopoulou
- Charité, Campus Virchow Klinikum, Frauenklinik, Augustenburger Platz 1, 13353 Berlin, Germany
| | - B Schmalfeldt
- Klinikum rechts der Isar der Technischen Universitaet, Frauen- und Poliklinik, Ismaninger Str. 22, 81675 Munich, Germany
| | - A Burges
- Klinikum der Universitaet Muenchen, Campus Grosshadern, Klinik und Poliklinik fuer Frauenheilkunde und Geburtshilfe, Marchioninistr.15, 81377 Munich, Germany
| | - N Ewald-Riegler
- Dr Horst Schmidt Klinik GmbH, Klinik fuer Gynaekologie und gynaekologische Onkologie, Ludwig-Erhard-Str. 100, 65199 Wiesbaden, Germany
| | - N de Gregorio
- Universitaetsklinikum Ulm, Frauenklinik, Prittwitzstrasse 43, 89075 Ulm, Germany
| | - F Hilpert
- Universitaetsklinikum Schleswig-Holstein, Campus Kiel, Klinik fuer Gynaekologie und Geburtshilfe, Michaelisstrasse 16, 24105 Kiel, Germany
| | - T Fehm
- 1] Universitaetsklinikum Tuebingen, Department fuer Frauengesundheit, Calwerstrasse 7, 72076 Tuebingen, Germany [2] Universitaetsklinikum Duesseldorf, Universitaetsfrauenklinik, Moorenstrasse 5, 40225 Duesseldorf, Germany
| | - W Meier
- Evangelisches Krankenhaus, Frauenklinik, Kirchfeldstrasse 40, 40217 Duesseldorf, Germany
| | - P Hillemanns
- Medizinische Hochschule Hannover, Frauenklinik, Carl-Neuberg-Str. 1, 30625 Hannover, Germany
| | - L Hanker
- 1] Klinikum der J.W. Goethe-Universitaet, Zentrum fuer Frauenheilkunde und Geburtshilfe, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany [2] Universitaetsklinikum Schleswig-Holstein, Campus Luebeck, Klinik fuer Gynaekologie und Geburtshilfe, Ratzeburger Allee 160, 23562 Luebeck, Germany
| | - A Hasenburg
- Universitaetsklinikum Freiburg, Frauenklinik, Hugstetter Str. 55, 79106 Freiburg im Breisgau, Germany
| | - H-G Strauss
- Universitaetsklinikum Halle (Saale), Universitaetsklinik und Poliklinik fuer Gynaekologie, Ernst-Grube-Str. 40, 06120 Halle (Saale), Germany
| | - M Hellriegel
- Georg-August-Universitaet Goettingen, Gynaekologie und Geburtshilfe, Robert-Koch-Str. 40, 37075 Goettingen, Germany
| | - P Wimberger
- 1] Technische Universitaet Dresden, Klinik und Poliklinik fuer Frauenheilkunde und Geburtshilfe, Fetscherstr. 74, 01307 Dresden, Germany [2] Universitaetsklinikum Essen, Klinik fuer Frauenheilkunde und Geburtshilfe, Essen, Germany
| | - S Kommoss
- 1] Dr Horst Schmidt Klinik GmbH, Klinik fuer Gynaekologie und gynaekologische Onkologie, Ludwig-Erhard-Str. 100, 65199 Wiesbaden, Germany [2] Universitaetsklinikum Tuebingen, Department fuer Frauengesundheit, Calwerstrasse 7, 72076 Tuebingen, Germany
| | - F Kommoss
- Institut fuer Pathologie, Referenzzentrum fuer Gynaekopathologie, A2,2, 68159 Mannheim, Germany
| | - S Hauptmann
- 1] Universitaetsklinikum Halle (Saale), Universitaetsklinik und Poliklinik fuer Gynaekologie, Ernst-Grube-Str. 40, 06120 Halle (Saale), Germany [2] Institut fuer Pathologie Trier-Dueren-Duesseldorf, Roonstrasse 30, 52351 Dueren, Germany
| | - A du Bois
- Kliniken Essen-Mitte, Klinik fuer Gynaekologische Onkologie, Henricistrasse 92, 45136 Essen, Germany
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Zaby K, Staebler A, Taran A, McConechy M, Rozenberg N, Huntsman D, Gilks B, Anglesio M, Brucker S, Fend F, Kommoss F, Wallwiener D, Kommoss S. Diagnostik adulter Granulosazelltumoren unter Berücksichtigung aktueller Forschungsergebnisse. Geburtshilfe Frauenheilkd 2014. [DOI: 10.1055/s-0034-1388355] [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: 10/24/2022] Open
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Grevenkamp F, Kommoss F, Taran FA, Lax S, Kommoss F, Wallwiener D, Brucker S, Fend F, Kommoss S, Staebler A. Konsensuspanel zur histopathologische Begutachtung von Endometriumkarzinomen: Klinische Bedeutung und Stellenwert im Rahmen translationaler Forschungsprojekte. Geburtshilfe Frauenheilkd 2014. [DOI: 10.1055/s-0034-1388529] [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: 10/24/2022] Open
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18
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Kommoss F, Grevenkamp F, Fend F, Taran FA, Brucker S, Wallwiener D, Kommoss F, Lax S, Staebler A, Kommoss S. L1CAM-Immunhistochemie: Prüfung einer vielversprechenden Option im Management früher Typ 1 Endometriumkarzinome. Geburtshilfe Frauenheilkd 2014. [DOI: 10.1055/s-0034-1388415] [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: 10/24/2022] Open
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Maaßen M, Anglesio M, Staebler A, Wallwiener D, Kommoss F, McConechy M, Karnezis A, Chang HL, Huntsman DG, Gilks CB, Brucker S, Taran FA, Kommoss S. Synchronous stage IA endometrial and ovarian carcinomas share common mutations: implications for tumour evolution and clinical staging. Geburtshilfe Frauenheilkd 2014. [DOI: 10.1055/s-0034-1388327] [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: 10/24/2022] Open
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Trillsch F, Mahner S, Woelber L, Vettorazzi E, Reuss A, Ewald-Riegler N, de Gregorio N, Fotopoulou C, Schmalfeldt B, Burges A, Hilpert F, Fehm T, Meier W, Hillemanns P, Hanker L, Hasenburg A, Strauss HG, Hellriegel M, Wimberger P, Baumann K, Keyver-Paik MD, Canzler U, Wollschlaeger K, Forner D, Pfisterer J, Schroeder W, Muenstedt K, Richter B, Kommoss F, Hauptmann S, du Bois A. Age-dependent differences in borderline ovarian tumours (BOT) regarding clinical characteristics and outcome: results from a sub-analysis of the Arbeitsgemeinschaft Gynaekologische Onkologie (AGO) ROBOT study. Ann Oncol 2014; 25:1320-1327. [PMID: 24618151 DOI: 10.1093/annonc/mdu119] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [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: 12/27/2022] Open
Abstract
BACKGROUND Approximately one-third of all borderline ovarian tumours (BOT) are diagnosed in patients with child-bearing potential. Detailed information regarding their specific characteristics and prognostic factors is limited. METHODS Clinical parameters of BOT patients treated between 1998 and 2008 in 24 German centres were retrospectively investigated. Central pathology review and prospective follow-up were carried out. Patients <40 versus ≥40 years were analysed separately and then compared regarding clinico-pathological variables and prognosis. RESULTS A total of 950 BOT patients with a median age of 49.1 (14.1-91.5) years were analysed [280 patients <40 years (29.5%), 670 patients ≥40 years (70.5%)]. Fertility-preserving surgery was carried out in 53.2% (149 of 280) of patients <40 years with preservation of the primarily affected ovary in 32 of these 149 cases (21.5%). Recurrence was significantly more frequent in patients <40 years (19.0% versus 10.1% 5-year recurrence rate, P < 0.001), usually in ovarian tissue, whereas disease-specific overall survival did not differ between the subgroups. In case of recurrent disease, malignant transformation was less frequent in younger than in older patients (12.0% versus 66.7%, P < 0.001), mostly presenting as invasive peritoneal carcinomatosis. Multivariate analysis for patients <40 years identified advanced International Federation of Gynecology and Obstetrics (FIGO) stage and fertility-sparing approach as independent prognostic factors negatively affecting progression-free survival (PFS) while, for patients ≥40 years, higher FIGO stage and incomplete staging was associated with impaired PFS. CONCLUSIONS Despite favourable survival, young BOT patients with child-bearing potential are at higher risk for disease recurrence. However, relapses usually remain BOT in the preserved ovaries as opposed to older patients being at higher risk for malignant transformation in peritoneal or distant localisation. Therefore, fertility-sparing approach can be justified for younger patients after thorough consultation.
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Affiliation(s)
- F Trillsch
- Department of Gynaecology and Gynaecologic Oncology
| | - S Mahner
- Department of Gynaecology and Gynaecologic Oncology.
| | - L Woelber
- Department of Gynaecology and Gynaecologic Oncology
| | - E Vettorazzi
- Department of Medical Biometry and Epidemiology, Universitätsklinikum Hamburg-Eppendorf, Hamburg
| | - A Reuss
- Department of Coordinating Center for Clinical Trials, Marburg
| | - N Ewald-Riegler
- Department of Gynaecology and Gynaecologic Oncology, Dr Horst Schmidt Klinik GmbH, Wiesbaden
| | - N de Gregorio
- Department of Gynaecolgy and Obstetrics, Universitätsklinikum Ulm, Ulm
| | - C Fotopoulou
- Department of Gynaecolgy, Charité, Campus Virchow Klinikum, Berlin
| | - B Schmalfeldt
- Department of Obstetrics and Gynaecolgy, Klinikum Rechts der Isar der Technischen Universität, Munich
| | - A Burges
- Department of Obstetrics and Gynaecolgy, Klinikum der Universität München, Munich
| | - F Hilpert
- Department of Gynaecolgy and Obstetrics, Universitätsklinikum Schleswig-Holstein, Kiel
| | - T Fehm
- Department of Gynaecolgy and Obstetrics, Universitätsklinikum Tübingen, Tuebingen
| | - W Meier
- Department of Gynaecolgy and Obstetrics, Evangelisches Krankenhaus, Duesseldorf
| | - P Hillemanns
- Department of Gynaecolgy and Obstetrics, Medizinische Hochschule Hannover, Hannover
| | - L Hanker
- Department of Gynaecolgy and Obstetrics, Klinikum der J.W. Goethe-Universität, Frankfurt/M; Department of Gynaecolgy and Obstetrics, Universitätsklinikum Schleswig-Holstein, Luebeck
| | - A Hasenburg
- Department of Obstetrics and Gynaecolgy, Universitätsklinikum Freiburg, Freiburg
| | - H G Strauss
- Department of Gynaecolgy and Obstetrics, Universitätsklinikum Halle/S., Halle/S
| | - M Hellriegel
- Department of Gynaecolgy and Obstetrics, Georg-August-Universität Göttingen, Goettingen
| | - P Wimberger
- Clinic of Gynaecolgy and Obstetrics, Universitätsklinikum Essen, Essen; Department of Gynaecolgy and Obstetrics, Universitätsklinikum Carl Gustav Carus, Dresden
| | - K Baumann
- Department of Gynaecolgy, Endocrinology and Oncology, Universitätsklinikum Gießen u. Marburg GmbH, Marburg
| | - M D Keyver-Paik
- Department of Obstetrics and Gynaecolgy, Rheinische Friedrich-Wilhelms-Universität, Bonn
| | - U Canzler
- Department of Gynaecolgy and Obstetrics, Universitätsklinikum Carl Gustav Carus, Dresden
| | - K Wollschlaeger
- Department of Gynaecolgy and Obstetrics, Universitätsklinikum Magdeburg, Magdeburg
| | - D Forner
- Department of Gynaecolgy and Obstetrics, Sana-Klinikum Remscheid, Remscheid
| | - J Pfisterer
- Department of Gynaecolgy and Obstetrics, Städtisches Klinikum Solingen gGmbH, Solingen; Zentrum für Gynäkologische Onkologie, Kiel
| | | | - K Muenstedt
- Department of Obstetrics and Gynaecolgy, Universitätsklinikum Gießen, Gießen
| | - B Richter
- Department of Gynaecology and Obstetrics, Elblandkliniken Meißen-Radebeul GmbH & Co. KG, Radebeul
| | - F Kommoss
- Institute of Pathology, Referenzzentrum für Gynäkopathologie, Mannheim
| | - S Hauptmann
- Department of Gynaecolgy and Obstetrics, Universitätsklinikum Halle/S., Halle/S; Institute of Pathology, Trier-Dueren-Duesseldorf, Dueren
| | - A du Bois
- Department of Gynaecolgy and Gynaecolgic Oncology, Kliniken Essen-Mitte, Essen, Germany
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Wagner U, Harter P, Hilpert F, Mahner S, Reuß A, du Bois A, Petru E, Meier W, Ortner P, König K, Lindel K, Grab D, Piso P, Ortmann O, Runnebaum I, Pfisterer J, Lüftner D, Frickhofen N, Grünwald F, Maier BO, Diebold J, Hauptmann S, Kommoss F, Emons G, Radeleff B, Gebhardt M, Arnold N, Calaminus G, Weisse I, Weis J, Sehouli J, Fink D, Burges A, Hasenburg A, Eggert C. S3-Guideline on Diagnostics, Therapy and Follow-up of Malignant Ovarian Tumours: Short version 1.0 - AWMF registration number: 032/035OL, June 2013. Geburtshilfe Frauenheilkd 2013; 73:874-889. [PMID: 24771937 PMCID: PMC3859160 DOI: 10.1055/s-0033-1350713] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
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22
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Schmalfeldt B, Burges A, Hilpert F, Reuß A, Fehm T, Meier W, Kommoss F, Hillemanns P, Hanker L, Hasenburg A, Strauß HG, Hellriegel M, Wimberger P, Kommoss S, Ewald-Riegler N, de Gregorio N, Mahner S, Fotopoulou C, Hauptmann S, du Bois A. Krankheitsverlauf von Patientinnen mit Borderline Tumoren des Ovars: Ergebnisse der multizentrischen AGO „ROBOT“ Studie. Geburtshilfe Frauenheilkd 2012. [DOI: 10.1055/s-0032-1318536] [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: 10/28/2022] Open
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23
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Ewald-Riegler N, du Bois O, Fisseler-Eckhoff A, Kommoss F, Harter P, Traut A, Hils R, Du Bois A. Incidence of recurrence and prognostic factors of borderline tumors of the ovary. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.e15522] [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: 11/20/2022] Open
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24
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Brochhausen C, Bittinger F, Schmitt VH, Kommoss F, Lehr HA, Heintz A, Kirkpatrick CJ. Expression of E-selectin and vascular cell adhesion molecule-1 in so-called 'negative' appendices: first results to support the pathological diagnosis in borderline cases. Eur Surg Res 2010; 45:350-5. [PMID: 21099224 DOI: 10.1159/000321698] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2010] [Accepted: 10/05/2010] [Indexed: 11/19/2022]
Abstract
BACKGROUND Since the rate of histologically 'negative' appendices still ranges between 15 and 20%, appendicitis in 'borderline' cases remains a challenging disease. As previously described, cell adhesion molecule expression correlates with different stages of appendicitis. Therefore, it was of interest to determine whether the 'negative' appendix correlated with the absence of E-selectin or vascular cell adhesion molecule-1 (VCAM-1). METHODS Nineteen grossly normal appendices from a series of 120 appendectomy specimens from patients with suspected appendicitis were analysed in frozen sections for the expression of E-selectin and VCAM-1. As control, 5 normal appendices were stained. RESULTS This study showed a coexpression of E-selectin and VCAM-1 in endothelial cells in early and recurrent appendicitis. In patients with symptoms for less than 6 h, only E-selectin was detected. Cases with fibrosis and luminal obliteration were only positive for VCAM-1. In cases of early appendicitis with symptoms of less than 6 h duration, a discordance between histological and immunohistochemical results was found. CONCLUSIONS This report indicates that E-selectin and VCAM-1 expression could be useful parameters in the diagnosis of appendicitis in borderline cases.
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Affiliation(s)
- C Brochhausen
- Institute of Pathology, University Medical Centre Mainz, Mainz, Germany. brochhausen @ pathologie.klinik.uni-mainz.de
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25
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Madjar H, du Bois A, Kommoss F, Meerpohl H, Pfleiderer A. Implementation of Doppler Ultrasound for Therapy Control of Breast Malignancies Treated with Chemotherapy. Oncol Res Treat 2009. [DOI: 10.1159/000218255] [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: 11/19/2022]
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26
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Lobmaier SM, Ortiz Velasquez J, Schmalfeldt B, Kommoss F, Pildner von Steinburg S, Schneider KTM. Akutes Abdomen bei Teratokarzinom in der Schwangerschaft. Z Geburtshilfe Neonatol 2009. [DOI: 10.1055/s-0029-1222981] [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: 10/20/2022]
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27
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Engels K, du Bois A, Harter P, Fisseler-Eckhoff A, Kommoss F, Stauber R, Kaufmann M, Nekljudova V, Loibl S. VEGF-A and i-NOS expression are prognostic factors in serous epithelial ovarian carcinomas after complete surgical resection. J Clin Pathol 2009; 62:448-54. [PMID: 19126566 DOI: 10.1136/jcp.2008.063859] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
AIMS Clinical stage at the time of diagnosis and achievement of complete macroscopic resection during initial surgery are key factors determining the outcome of ovarian cancer. However, prediction of outcome lacks accuracy and more reliable prognostic factors are required. Therefore, an analysis and evaluation of key angiogenic factors was carried out to determine their diagnostic and prognostic value in serous ovarian cancer. METHODS Expression levels of vascular endothelial growth factor (VEGF)-A, hypoxia-inducible factor (HIF)1-alpha and inducible nitric oxide synthase (i-NOS) were analysed by immunohistochemistry in a homogenous group of 112 patients with serous adenocarcinoma of the ovary. Vascular density as an indicator of angiogenesis was assessed using the Chalkley eyepiece method after staining for CD34. The correlation of these data with survival and established prognostic factors such as histological grade, Federation of Gynecology and Obstetrics (FIGO) stage, and residual tumour after surgery, was evaluated. Survival analyses, multivariate analyses and correlation tests were performed. RESULTS In the patient group with macroscopic complete tumour resection (R0) there was a significant correlation between VEGF-A and i-NOS expression. Kaplan-Meier analysis further revealed improved progression-free survival for R0 patients with VEGF-A-positive and i-NOS-negative tumours. The predictive relevance of VEGF-A regarding progression-free survival was sustained in multivariate analysis using FIGO stage, grading and resection status as fixed variables. CONCLUSION VEGF-A and i-NOS are prognostic markers for clinical outcome in serous ovarian cancer patients with macroscopic complete tumour resection (R0). Hence, pre-therapeutic assessment of VEGF-A as predictive factor for an antiangiogenic therapy might be of clinical value.
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Affiliation(s)
- K Engels
- Department of Pathology, Johann Wolfgang Goethe University, Frankfurt am Main, Germany.
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28
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Kommoss F, Pfisterer J, Peters F, Kirkpatrick C, Hilgarth M. Ektope Deziduareaktion - möglicher Anlaß zur kolposkopischen, histologischen und intraoperativen Fehldiagnose. Geburtshilfe Frauenheilkd 2008. [DOI: 10.1055/s-2007-1022741] [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: 10/21/2022] Open
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30
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Horn LC, Einenkel J, Höckel M, Kölbl H, Kommoss F, Lax SF, Reich O, Riethdorf L, Schmidt D. Pathologisch-anatomische Aufarbeitung und Befundung von Dysplasien und Karzinomen der Cervix uteri*. Pathologe 2007; 28:249-60. [PMID: 16838175 DOI: 10.1007/s00292-006-0845-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
A careful macroscopic description with selection of representative tissue for histological examination is required for quality assurance, for assessing prognostic factors and for answering legal questions in (pre)cancerous lesions of the cervix uteri. Exact and standardized gross inspection and preparation are decisive for the quality of the histopathological statement. The extent of cervical carcinomas should be given in three dimensions, including the relative depth of invasion into the cervical wall. The report should include size, type (according to the WHO classification) and grading of the tumor, the presence of lymphatic as well as blood vessel invasion and perineural involvement. The statement for resection margins should include the vaginal, parametrial, rectal and vesical directions. It is also mandatory to document the number of lymph nodes with metastatic disease in relation to the total number of nodes investigated. The staging should follow the TNM system. In the handling of conisation specimens, it is important to appropriately document localization, horizontal expansion, depth of invasion including microinvasion of any dysplastic or malignant lesions. Clockwise dissection of the conisation specimen, total submission, and step sections are recommended. The preparation of exenteration specimens is a highly skilled job: the exact tumor dimension should be given in its relation to all resected organs and structures with special focus on resection margins.
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Affiliation(s)
- L-C Horn
- Abt. für Gynäko- & Perinatalpathologie, Institut für Pathologie, Universität, Liebigstrasse 26, 04103, Leipzig.
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Abstract
Transitional cell carcinoma of the ovary (TCC-O) is a less common type of malignant surface epithelial-stromal tumor of the ovary, still with uncertain incidence. Histologically, TCC-O resembles urothelial carcinoma of the urinary system, and by definition does not contain a Brenner tumor component. TCC-O may not be a bona fide urothelial neoplasm, however, but rather a lesion of the Müllerian type derived from the ovarian surface epithelium. This notion is supported by the existence of mixed tumors consisting of TCC-O and other histological types of ovarian carcinoma, as well as the observation that TCC-O has a Müllerian type but not a urothelial-like immunohistochemical profile. Besides metastatic urothelial carcinoma of the urinary tract, the other types of ovarian carcinoma, as well as sex cord-stromal tumors such as adult granulosa cell tumors, have to be considered in the differential diagnosis of TCC-O. A recent analysis of a large series of advanced ovarian carcinomas treated by radical surgery and postoperative chemotherapy confirms studies that had suggested that TCC-O has a better prognosis (with current treatment) than that of the other histological types of ovarian carcinoma. Further studies applying standardized histopathological criteria are needed to clarify the true incidence and behavior of TCC-O. In addition, it is important to study the biological and molecular background of this apparently less aggressive phenotype.
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Affiliation(s)
- F Kommoss
- Institut für Pathologie, Referenzzentrum für Gynäkopathologie, A2/2, 68159 Mannheim, Germany.
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Abstract
Sex cord markers comprise proteins and hormones that are produced in sex cord-derivatives in normal ovaries and testes as well as in gonadal sex cord-stromal tumors. Sex cord markers (e.g. inhibin-alpha) are used clinically as serum tumor markers. Immunohistochemical staining of sex cord markers may be helpful in the differential diagnosis of ovarian sex cord-stromal tumors versus surface epithelial-stromal tumors, germ cell tumors, other ovarian tumors, and ovarian metastases. Inhibin-alpha has been shown to be the most specific marker of sex cord differentiation. In comparison, calretinin is a somewhat more sensitive albeit less specific marker. Currently, an immunohistochemical panel including inhibin-alpha and calretinin is considered most helpful in the differential diagnosis of ovarian sex cord-stromal tumors. CD99, Müllerian inhibiting substance (MIS), melan A and CD10, being sex cord markers of limited sensitivity and specificity, should only be used as part of an antibody panel in specific diagnostic settings. EMA, CK7 and chromogranin are considered additional markers that may be useful in the differential diagnosis of ovarian sex cord-stromal tumors.
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Affiliation(s)
- F Kommoss
- Institut für Pathologie, Referenzzentrum für Gynäkopathologie, A2/2, 68159 Mannheim, Germany.
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Abstract
Teratomas are the most frequent germ cell tumors of the ovary. Two main groups can be distinguished: mature and immature teratomas. Mature teratomas are benign tumors, which are most often composed of derivatives of two or three germ cell layers. Only in rare cases is the transition into a malignant tumor observed (most often squamous cell carcinoma). In contrast, immature teratomas are malignant ovarian tumors. They contain immature tissue elements in addition to the mature components, most often consisting of immature neural tissue. Histologically, this tumor component can be identified as neurotubules or rosettes. The proportion of immature tissue elements defines the grade of immaturity. Four grades have been defined in to the WHO classification. Grade 0 represents a mature teratoma. With the exception of childhood cases, grade 2 and 3 immature teratomas are treated with chemotherapy. In childhood cases, foci of yolk sac tumor (YST) must be looked for, since this determines the prognosis. If a focus of YST is present, the patient is treated with chemotherapy. Both in cases of mature and immature teratoma, peritoneal implants can be found (gliomatosis peritonei), which are also graded. In cases of immature peritoneal implants, patients are also treated with chemotherapy. Gliomatosis peritonei is most likely derived from metaplasia of subperitoneal stem cells; it does not represent a metastatic disease of the ovarian teratoma.
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Affiliation(s)
- D Schmidt
- Institut für Pathologie, A2,2, 68159 Mannheim, Germany.
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Abstract
Clinically and morphologically, two types of granulosa cell tumor can be distinguished, the more frequent adult type and the juvenile type. In the adult type, different growth patterns can be observed: microfollicular (most frequent, characterized by Call-Exner bodies), macrofollicular, trabecular, insular, solid-tubular, gyriform and diffuse (sarcomatoid). The juvenile type is characterized by solid and follicular structures. The neoplastic granulosa cells in the adult type have limited cytoplasm and haphazardly arranged angular, pale, mostly grooved nuclei. In the juvenile type, the cells have ample eosinophilic cytoplasm and polymorphic, sometimes bizarre nuclei, which are usually non-grooved. The number of mitoses in the adult type usually does not exceed 2/10 HPF, whereas it is considerably higher in the juvenile type, including atypical mitoses. A common feature in both types of tumor is the expression of inhibin-alpha, calretinin and CD 99. Epithelial membrane antigen is negative. Molecular genetics has demonstrated loss of heterozygosity at 19p13.3 in 52% of the cases. Besides chromosomal aberrations, there are a large number of cytogenetic anomalies. The most important prognostic factor in both types of tumor is tumor stage. Whereas recurrences in the adult type can develop even after decades, in the juvenile type they usually occur during the first 3 years after diagnosis.
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Affiliation(s)
- D Schmidt
- Institut für Pathologie, A2,2, 68159 Mannheim, Germany.
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Kommoss S, du Bois A, Ridder R, Trunk MJ, Schmidt D, Pfisterer J, Kommoss F. Independent prognostic significance of cell cycle regulator proteins p16(INK4a) and pRb in advanced-stage ovarian carcinoma including optimally debulked patients: a translational research subprotocol of a randomised study of the Arbeitsgemeinschaft Gynaekologische Onkologie Ovarian Cancer Study Group. Br J Cancer 2007; 96:306-13. [PMID: 17242700 PMCID: PMC2360015 DOI: 10.1038/sj.bjc.6603531] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
The purpose of the study is to test the hypothesis that expression of cell cycle regulatory proteins p16INK4a and pRb is significantly associated with prognosis in ovarian carcinomas. We performed immunohistochemical analysis of p16INK4a and pRb expression and correlated with survival in a series of 300 patients with FIGO stage IIb-IV ovarian carcinoma which were enrolled in a randomized prospective trial evaluating two different platinum and paxlitaxel chemotherapy combinations after radical surgery. p16INK4a negative tumours (17/300; 6%) had a significantly worse prognosis (univariate analysis, P<0.001; multivariate analysis: odds ratio 2.41, P=0.009). Among p16INK4a-positive tumours (283 out of 300; 94%), survival was better for patients with intermediate expression as compared to low or high expression levels (P=0.001). High expression levels of pRb were associated with an incremental deterioration of prognosis (univariate analysis, P=0.004; multivariate analysis: odds ratio 2.98, P=0.002). This observation held also true in the subgroup of optimally debulked patients (n=82), in whom the most important established prognostic factor, postoperative residual tumour cannot be applied. In conclusion p16INK4a and pRb are independent prognostic factors in advanced-stage ovarian carcinomas after radical surgery and postoperative chemotherapy. High pRb expression is a significant prognosticator in optimally debulked patients and may hold potential for subgroup stratification in postoperative treatment.
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Affiliation(s)
- S Kommoss
- Dr-Horst-Schmidt-Klinik (HSK) Wiesbaden, Department of Gynecology & Gynecologic Oncology, Ludwig - Erhard - Str. 100, Wiesbaden 65199, Germany.
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Vavilis D, Papadopoulos N, Agorastos T, Efstratiou I, Kommoss F, Bontis IN. Primary ovarian angiosarcoma--review of the literature and report of a case with coexisting chylothorax. EUR J GYNAECOL ONCOL 2007; 28:287-9. [PMID: 17713094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
BACKGROUND Primary ovarian angiosarcoma is a very rare gynaecologic malignancy with poor prognosis and uncertain, up-to-date, treatment options. Its exact diagnosis is challenging for surgeons and difficult for pathologists. There are only a few cases reported in the international literature. CASE We report a case of primary pure ovarian angiosarcoma with coexisting chylothorax which is, to the best of our knowledge, the first reported case. An extensive review of the literature analyzing all clinical and pathological parameters related to this condition is presented. RESULT In spite of all therapeutic efforts, surgical and medical, prognosis of ovarian angiosarcoma remains very poor in most cases. CONCLUSION Primary ovarian angiosarcoma is a rare and aggressive malignancy. The report of such cases is interesting in order to exchange knowledge and experience, and possibly to further improve our diagnostic and therapeutic capabilities.
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Affiliation(s)
- D Vavilis
- 1st Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, Greece
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37
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Harter P, Neugebauer B, Gnauert K, Buhrmann C, Traut A, Fisseler-Eckhoff A, Kommoss F, du Bois A. Klinisches Managment von Borderlinetumoren (Tumoren mit niedrig malignem Potential, LMP). Geburtshilfe Frauenheilkd 2006. [DOI: 10.1055/s-2006-952824] [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: 10/20/2022] Open
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38
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Hanker LC, Engels K, Moll P, Harter P, Fissler-Eckhoff A, Kommoss F, Kaufmann M, Loibl S. VEGF-A und COX-2 Expression korrelieren mit der Platinresistenz beim Ovarial-Ca. Geburtshilfe Frauenheilkd 2006. [DOI: 10.1055/s-2006-952833] [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: 10/20/2022] Open
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Engels K, Moll P, Harter P, Du Bois A, Fisseler-Eckhoff A, Kommoss F, Kaufmann M, Loibl S. VEGF-A and COX-2 expression correlate with platinum resistance in ovarian cancers. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.5062] [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: 11/20/2022] Open
Abstract
5062 Background: Regulators of angiogenesis such as VEGF-A and cell cycle such as p53 and COX-2 influence tumor behavior and response to chemotherapy. Methods: 114 patients with primary ovarian cancer treated in Frankfurt or Wiesbaden between 1999 and 2004 were examined. Primary surgery was followed by a platinum and taxane based chemotherapy in all patients. Expression of i-NOS, COX-2, VEGF-A, HIF-1 alpha was analyzed immunohistochemically using tissue micro arrays of primary tumor samples. Results were scored according to staining intensity and percentage of positive tumor cells resulting in an immune-reactive score (IRS) from 0 to 12. Vascularity was assessed using the Chalkley-Grid method after highlighting vessels with CD34 antibodies in whole tissue sections. These results were correlated with classical prognostic factors and survival. Non-parametric correlations were done using Spearman’s rho, correlations were significant at the 0,05 level (2-tailed). Results: The median age at the time of surgery was 63y (33–89y). The majority of the patients (85%) had advanced disease (FIGO III-IV). Tumor grading was G1 in 2%, G2 in 37%, and G3 in 61%. Expressions were as follows: i-NOS 60% positive (IRS ≥4); COX-2 50% positive (IRS ≥5); VEGF-A 50% strong (IRS ≥8), 32% moderate (IRS 4–7), 18% weak (IRS ≤4); HIF-1 alpha 37% positive (IRS ≥3), p53 33% weak (IRS ≤4), 67% strong (IRS >4); vascularity 41% low (≤5), 52% moderate (6–9), 7% high (>9). I-NOS correlated positively with COX-2 (p = 0,03), VEGF-A (p = 0,05), and p53 (p = 0,01). Grading correlated positively with HIF-1 alpha (p = 0,02) and vascularity (p = 0,01). Up to now none of the new parameters did show correlations with recurrence free survival (median follow-up 36 months). Platinum resistant tumors (time from primary diagnosis to relapse <12 months) were significantly more often negative for VEGF-A (p = 0,005) and COX-2 (p = 0,02). Conclusions: I-NOS correlates with markers of angiogenesis and cell cycle regulation. VEGF-A and COX-2 expression might predict platinum resistance in ovarian cancers. No significant financial relationships to disclose.
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Affiliation(s)
- K. Engels
- University of Frankfurt, Frankfurt, Germany; University Hospital, Frankfurt, Germany; Dr. Horst Schmidt Klinik, Wiesbaden, Germany; Centre of Pathology, Mannheim, Germany
| | - P. Moll
- University of Frankfurt, Frankfurt, Germany; University Hospital, Frankfurt, Germany; Dr. Horst Schmidt Klinik, Wiesbaden, Germany; Centre of Pathology, Mannheim, Germany
| | - P. Harter
- University of Frankfurt, Frankfurt, Germany; University Hospital, Frankfurt, Germany; Dr. Horst Schmidt Klinik, Wiesbaden, Germany; Centre of Pathology, Mannheim, Germany
| | - A. Du Bois
- University of Frankfurt, Frankfurt, Germany; University Hospital, Frankfurt, Germany; Dr. Horst Schmidt Klinik, Wiesbaden, Germany; Centre of Pathology, Mannheim, Germany
| | - A. Fisseler-Eckhoff
- University of Frankfurt, Frankfurt, Germany; University Hospital, Frankfurt, Germany; Dr. Horst Schmidt Klinik, Wiesbaden, Germany; Centre of Pathology, Mannheim, Germany
| | - F. Kommoss
- University of Frankfurt, Frankfurt, Germany; University Hospital, Frankfurt, Germany; Dr. Horst Schmidt Klinik, Wiesbaden, Germany; Centre of Pathology, Mannheim, Germany
| | - M. Kaufmann
- University of Frankfurt, Frankfurt, Germany; University Hospital, Frankfurt, Germany; Dr. Horst Schmidt Klinik, Wiesbaden, Germany; Centre of Pathology, Mannheim, Germany
| | - S. Loibl
- University of Frankfurt, Frankfurt, Germany; University Hospital, Frankfurt, Germany; Dr. Horst Schmidt Klinik, Wiesbaden, Germany; Centre of Pathology, Mannheim, Germany
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Schmalfeldt B, du Bois A, Burges A, Emons G, Fink D, Gropp M, Hasenburg A, Jäger W, Kimmig R, Kiechle M, Kommoss F, Kreienberg R, Kuhn W, Lück HJ, Meier W, Münstedt K, Ortmann O, Pfisterer J, Richter B, Runnebaum I, Schröder W, Sehouli J, Tanner B, Wagner U, Weis J. Diagnostik und Therapie maligner Ovarialtumoren 2005: Die Empfehlungen der Kommission Ovar der AGO. ACTA ACUST UNITED AC 2006; 128:11-7. [PMID: 16450281 DOI: 10.1055/s-2006-921345] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Recommendations for diagnosis and treatment of malignant ovarian tumors with regard to the most recent data were worked out in a consensus process and valued by level of evidence (LoE) and grade of recommendation (GoR) of the Canadian Task Force for Preventive Health Care by the members of the Kommission Ovar der Arbeitsgemeinschaft für Gynäkologische Onkologie (AGO) in June 2005. A short version of these guidelines is presented.
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Affiliation(s)
- B Schmalfeldt
- Frauenklinik der Technischen Universität München, Ismaninger Str. 2, 81675 München.
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Horn LC, Einenkel J, Höckel M, Kölbl H, Kommoss F, Lax SF, Riethdorf L, Schnürch HG, Schmidt D. Pathologisch-anatomische Aufarbeitung und Befundung von Lymphknoten bei gynäkologischen Malignomen. Pathologe 2005; 26:266-72. [PMID: 15915329 DOI: 10.1007/s00292-005-0764-3] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The nodal status is one of the strongest prognostic factors in gynecologic malignancies. Metastatic involvement of regional and distant lymph nodes represents the selection basis for adjuvant therapy in a large number of solid neoplasms. The number of resected lymph nodes is one of the most important parameters in the quality control of the surgical procedure, in particular with respect to radicality. The present paper provides recommendations for gross dissection, laboratory procedures and reporting for lymph node biopsies, lymph node dissections and sentinel lymph node biopsies (SLN) for cancers of the vulva, vagina, uterine cervix, endometrium, Fallopian tubes and the ovaries, submitted for the evaluation of metastatic disease. The pathologic oncology report should include information about the number and size of resected lymph nodes, the number of involved lymph nodes with the maximum size of metastases and the presence of paranodal infiltration. In addition, the detection of isolated tumor cells should be reported, particularly with respect to the detection method (immunostains or molecular methods). In cases of metastatic disease and carcinoma of unknown primary (CUP-syndrome), information should be given regarding the primary tumor.
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Affiliation(s)
- L-C Horn
- Abteilung für Gynäko- & Perinatalpathologie, Institut für Pathologie der Universität Leipzig.
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Abstract
Neuroendocrine carcinomas of the cervix are rare. They cover a wide age range occurring in young adult women and very old women. Two types are distinguished: small cell carcinoma (oat cell) and large cell neuroendocrine carcinoma. They either occur in pure form or in combination with adenocarcinoma or squamous cell carcinoma. By immunohistochemistry, the expression of at least one neuroendocrine marker (chromogranin, synaptophysin, NSE) is a constant finding. PRb protein can not be detected, whereas the expression of p53 varies. Typically, there is an association with a high risk HPV infection. HPV 18 is found more often than HPV 16. The prognosis is still poor with early metastases to regional lymph nodes and distant sites such as lung, liver, bone, and brain.
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Abstract
The introduction of a screening programme for carcinoma of the cervix uteri has lead to a reduction in the number of invasive carcinomas and to a relative increase in the frequency of preinvasive cervical lesions. The most frequent type of invasive cancer of the cervix is squamous cell carcinoma. Adenocarcinomas are much more infrequent. Special subtypes of squamous cell carcinomas are the papillary (squamotransitional) subtype, the verrrucous subtype and the lymphoepithelioma-like subtype. Among the various forms of adenocarcinoma, the mucinous subtype is the most frequent, either as endocervical or interstinal subtype. Much more rare are the serous and clear cell carcinomas. Great concern in daily diagnosis causes the adenoma malignum (minimal deviation adenocarcinoma), since this type of adenocarcinoma demonstrates only minor cytological atypia and greatly resembles the different types of endocervical glandular hyperplasia.A report on a cervical carcinoma should always include the typing and grading of the tumor. Immunohistochemical stains are often useful to distinguish the various types of primary cervical cancer and to distinguish these from metastatic lesions.
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Kommoss F, Schmidt D, Coerdt W, Olert J, Müntefering H. Immunohistochemical expression analysis of inhibin-alpha and -beta subunits in partial and complete moles, trophoblastic tumors, and endometrial decidua. Int J Gynecol Pathol 2001; 20:380-5. [PMID: 11603223 DOI: 10.1097/00004347-200110000-00011] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The expression of inhibin-alpha subunit has been described in normal placentas, hydatidiform moles, and trophoblastic tumors. We performed a double immunohistochemical expression analysis of inhibin-alpha and inhibin-beta subunits in a cytogenetically well characterized series of 21 complete and 22 partial hydatidiform moles, 2 placental site trophoblastic tumors, and one choriocarcinoma. Syncytiotrophoblastic cells were consistently inhibin-alpha and inhibin-beta positive in all hydatidiform moles and in the one choriocarcinoma. Cytotrophoblast was negative for both subunits in all trophoblastic lesions studied. While villous intermediate trophoblastic cells were consistently inhibin-alpha negative in all hydatidiform moles, focal inhibin-beta immunoreactivity was detected in villous intermediate trophoblast in approximately one third of complete and partial hydatidiform moles. Decidual stromal cells in 40 hydatidiform moles were inhibin-alpha and inhibin-beta positive in approximately one third of cases. Both placental site trophoblastic tumors were inhibin-alpha positive but inhibin-beta negative. Our findings indicate that inhibin-alpha and -beta subunits are consistently coexpressed in syncytiotrophoblast in complete and partial moles. Immunohistochemical detection of inhibin subunits may be useful in the differential diagnosis of trophoblastic lesions.
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Affiliation(s)
- F Kommoss
- Institut für Pathologie, A 2, 2, 68159 Mannheim, Germany
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45
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Kommoss F, Oliva E, Young RH, Bittinger F, Kirkpatrick CJ, Schmidt D. Expression of Müllerian Inhibiting Substance, CD99 and HEA125 in Ovarian Tumors. Geburtshilfe Frauenheilkd 2001. [DOI: 10.1055/s-2001-14147] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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Kommoss F, Sapi E, Flick MB, Kacinski BM. Phospho-fms (p-fms) Expression in Ovarian Sex Cord-stromal Tumors. Geburtshilfe Frauenheilkd 2001. [DOI: 10.1055/s-2001-13772] [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: 10/17/2022] Open
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47
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Schuler M, Herrmann R, De Greve JL, Stewart AK, Gatzemeier U, Stewart DJ, Laufman L, Gralla R, Kuball J, Buhl R, Heussel CP, Kommoss F, Perruchoud AP, Shepherd FA, Fritz MA, Horowitz JA, Huber C, Rochlitz C. Adenovirus-mediated wild-type p53 gene transfer in patients receiving chemotherapy for advanced non-small-cell lung cancer: results of a multicenter phase II study. J Clin Oncol 2001; 19:1750-8. [PMID: 11251006 DOI: 10.1200/jco.2001.19.6.1750] [Citation(s) in RCA: 159] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE To study the additional benefit from adenoviral p53 gene therapy in patients undergoing first-line chemotherapy for advanced non-small-cell lung cancer (NSCLC). PATIENTS AND METHODS Twenty-five patients with nonresectable NSCLC were enrolled in an open-label, multicenter phase II study of three cycles of regimen A, carboplatin (area under the curve, 6; day 1) plus paclitaxel (175 mg/m(2), day 1), or regimen B, cisplatin (100 mg/m(2), day 1) plus vinorelbine (25 mg/m(2), days 1, 8, 15, and 22) in combination with intratumoral injection of 7.5 x 10(12) particles of SCH 58500 (rAd/p53, day 1). Responses of individual tumor lesions were assessed after each cycle, and gene transfer was examined in posttreatment tumor biopsies using reverse transcriptase polymerase chain reaction. RESULTS There was no difference between the response rate of lesions treated with p53 gene therapy in addition to chemotherapy (52% objective responses) and lesions treated with chemotherapy alone (48% objective responses). Subgroup analysis according to the chemotherapy regimens revealed evidence for increased mean local tumor regressions in response to additional p53 gene therapy in patients receiving regimen B, but not in patients receiving regimen A. There was no survival difference between the two chemotherapy regimens, and the median survival of the cohort was 10.5 months (1-year survival, 44%). Transgene expression was confirmed in tumor samples from 68% of patients, and toxicities attributable to gene therapy were mild to moderate. CONCLUSION Intratumoral adenoviral p53 gene therapy appears to provide no additional benefit in patients receiving an effective first-line chemotherapy for advanced NSCLC.
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Affiliation(s)
- M Schuler
- Department of Medicine III, Johannes Gutenberg University, Mainz, Germany
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Kriegsmann J, Coerdt W, Kommoss F, Beetz R, Hallermann C, Müntefering H. Renal tubular dysgenesis (RTD) - an important cause of the oligohydramnion-sequence. Report of 3 cases and review of the literature. Pathol Res Pract 2001; 196:861-5. [PMID: 11156331 DOI: 10.1016/s0344-0338(00)80090-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Renal tubular dysgenesis (RTD) is a disorder characterized by neonatal renal failure and regular gross renal architecture, although the histological features of immature and shortened proximal tubules lead to neonatal death. The pathogenesis of this condition includes a congenital familial condition, a twin-twin transfusion syndrome, and an angiotensin-converting enzyme inhibitor intake by the mother. The clinical picture shows an association with oligohydramnia, pulmonary hypoplasia, and skull ossification defects. In the present paper, we report the occurrence of RTD in three infants of a consanguinous couple and compared our data with those of the literature. Our data confirm that late second trimester demonstration of oligohydramnion, with structurally normal kidneys and with or without skull ossification defects, allows the diagnosis of renal tubular dysgenesis, which, however, has to be confirmed by histological and immunohistological examinations of the kidney.
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Affiliation(s)
- J Kriegsmann
- Institute of Pathology, Johannes Gutenberg University, Mainz, Germany
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Koeppen C, Peters F, Kommoss F. Mammakarzinom mit osteoklastenartigen Riesenzellen - Gefahr der präoperativen Fehldeutung. Geburtshilfe Frauenheilkd 2001. [DOI: 10.1055/s-2001-11164] [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: 10/16/2022] Open
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Gaumann A, Hansen T, Köhler HH, Kommoss F, Mann W, Maurer J, Kirkpatrick CJ, Kriegsmann J. The Expression of Cathepsins in Osteoclast-like Giant Cells of an Anaplastic Thyroid Carcinoma with Tracheal Perforation. Pathol Res Pract 2001; 197:257-62. [PMID: 11358012 DOI: 10.1078/0344-0338-00044] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Anaplastic carcinoma of the thyroid gland (ACT) is a rapidly growing neoplasm with a very poor prognosis. In this study, we examined an ACT with osteoclast-like giant cells expressing matrix--degrading cysteine proteinases and their endogeneous inhibitor cystatin C. Bronchoscopic evaluation of a 50-year-old man suffering from hoarseness, dysphagia, and dyspnea revealed an irregular tumor mass infiltrating into the trachea and the cricothyroid ligament region. On histological examination, a necrotizing undifferentiated anaplastic carcinoma with osteoclast-like giant cells was detected. An immunohistochemical study of the tumor tissue was performed using a panel of 15 antibodies, including double labeling techniques. Most of the osteoclast-like multinucleated giant cells (MGC) expressed CD68 and cathepsin K. Colocalization of cathepsin B and its endogenous inhibitor cystatin C occurred in the majority of MGC. Mononuclear cells (MC) were positive for cathepsin B, cystatin C, and CD 68, but only faintly for cathepsin K. Expression of cathepsins B and K in the MGC of the ACT might contribute to the invasive behavior of this tumor, thus promoting metastatic ability and destruction of the cartilagenous trachea.
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Affiliation(s)
- A Gaumann
- Institut für Pathologie, Ohrenheilkunde, Universitätsklinik Mainz, Germany.
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