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Armbrust R, Chekerov R, Sander S, Biebl M, Chopra S, Krell J, Rinne N, Nixon K, Fotopoulou C, Sehouli J. Surgery due to mechanical bowel obstruction in relapsed ovarian cancer: clinical and surgical results of a bicentric analysis of 87 patients. Arch Gynecol Obstet 2021; 305:963-968. [PMID: 34596738 PMCID: PMC8969036 DOI: 10.1007/s00404-021-06237-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 09/06/2021] [Indexed: 11/28/2022]
Abstract
Introduction Mechanical bowel obstruction is a frequent acute and life-threatening event in relapsed ovarian cancer. Salvage surgery after failure of all conservative approaches, resulting in short bowel syndrome (SBS) constitutes a therapeutic dilemma. Our aim was to evaluate patients’ surgical and clinical outcome in these highly palliative situations. Previous, limited, data reported a high morbidity and mortality. However, recent surgical and therapeutical improvements in relapsed ovarian cancer (ROC) offer better identification of patients who might benefit from surgery in an effort to extend the window of opportunity to subsequently offer these patients novel systemic therapeutic approaches. Material and methods All subsequent ROC patients between 2012 and 2017 with acute mechanical bowel obstruction who underwent salvage extraperitoneal en bloc intestinal resection were retrospectively identified. Data were collected from two ESGO certified Ovarian Cancer Centers of Excellence (Charité Berlin and Imperial College London) and systematically evaluated regarding surgical and clinical outcomes. Results Overall, 87 ROC patients were included in the analysis (median age 56 years, range 24–88), 47% were platinum resistant. High grade serous was the most common histology (76%) while most of the patients (67%) had at least two previous lines of treatment. Mean observed OS was 7.8 months. After salvage surgery, 46% of the patients had a residual small bowel length < 180 cm and 18% > 180 cm resulting in 41% in need of total parental nutrition. In 80% of the patients a permanent stoma was necessary. 30d morbidity and mortality was 74% and 10%, respectively. More than half of the patients were able to receive further courses of chemotherapy after surgery. Discussion Salvage surgery for bowel obstruction in ROC patients needs careful consideration and identification of optimal surgical candidates to have the maximal therapeutic benefit. Despite the challenging morbidity profile, most patients managed to proceed to subsequent novel and conventional systemic treatment and so have their window of therapeutic opportunity extended.
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Affiliation(s)
- R Armbrust
- Department of Gynecology with Center for Oncological Surgery, Charité-University Hospital Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.
| | - R Chekerov
- Department of Gynecology with Center for Oncological Surgery, Charité-University Hospital Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - S Sander
- Department of Gynecology with Center for Oncological Surgery, Charité-University Hospital Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - M Biebl
- Department of Surgery, Charité-University Hospital Berlin, Berlin, Germany
| | - S Chopra
- Department of Surgery, Charité-University Hospital Berlin, Berlin, Germany
| | - Jonathan Krell
- West London Gynecological Cancer Centre, Imperial College NHS Trust, London, UK
| | - Natasha Rinne
- West London Gynecological Cancer Centre, Imperial College NHS Trust, London, UK
| | - Katherine Nixon
- West London Gynecological Cancer Centre, Imperial College NHS Trust, London, UK
| | - C Fotopoulou
- West London Gynecological Cancer Centre, Imperial College NHS Trust, London, UK
| | - J Sehouli
- Department of Gynecology with Center for Oncological Surgery, Charité-University Hospital Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
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Dimitrova D, Naghavi B, Richter R, Nasser S, Chekerov R, Braicu EI, David M, Blohmer J, Inci G, Torsten U, Oskay-Özcelik G, Blau I, Fersis N, Holzgreve A, Keil E, Keller M, Keilholz U, Sehouli J. Influence of migrant background on patient preference and expectations in breast and gynecological malignancies (NOGGO-expression V study): results of a prospective multicentre study in 606 patients in Germany. BMC Cancer 2021; 21:1018. [PMID: 34511112 PMCID: PMC8436522 DOI: 10.1186/s12885-021-08731-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Accepted: 08/26/2021] [Indexed: 11/23/2022] Open
Abstract
Background An effective cross-cultural doctor-patient communication is vital for health literacy and patient compliance. Building a good relationship with medical staff is also relevant for the treatment decision-making process for cancer patients. Studies about the role of a specific migrant background regarding patient preferences and expectations are lacking. We therefore conducted a multicentre prospective survey to explore the needs and preferences of patients with a migrant background (PMB) suffering from gynecological malignancies and breast cancer to evaluate the quality of doctor-patient communication and cancer management compared to non-migrants (NM). Methods This multicentre survey recruited patients with primary or recurrence of breast, ovarian, peritoneal, or fallopian tube cancer. The patients either filled out a paper form, participated via an online survey, or were interviewed by trained staff. A 58-item questionnaire was primarily developed in German and then translated into three different languages to reach non-German-speaking patients. Results A total of 606 patients were included in the study: 54.1% (328) were interviewed directly, 9.1% (55) participated via an online survey, and 36.8% (223) used the paper print version. More than one quarter, 27.4% (166) of the participants, had a migrant background. The majority of migrants and NM were highly satisfied with the communication with their doctors. First-generation migrants (FGM) and patients with breast cancer were less often informed about participation in clinical trials (p < 0.05) and 24.5% of them suggested the help of an interpreter to improve the medical consultation. Second and third-generation migrants (SGM and TGM) experienced more fatigue and nausea than expected. Conclusions Our results allow the hypothesis that training medical staff in intercultural competence and using disease-related patient information in different languages can improve best supportive care management and quality of life in cancer patients with migrant status. Supplementary Information The online version contains supplementary material available at 10.1186/s12885-021-08731-6.
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Affiliation(s)
- D Dimitrova
- Department of Gynecology with Center of Oncological Surgery, Charité University Medicine, Campus Virchow-Klinikum, Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - B Naghavi
- Charité Comprehensive Cancer Center, Charité University Medicine, Berlin, Germany
| | - R Richter
- Department of Gynecology with Center of Oncological Surgery, Charité University Medicine, Campus Virchow-Klinikum, Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - S Nasser
- Department of Gynecology with Center of Oncological Surgery, Charité University Medicine, Campus Virchow-Klinikum, Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - R Chekerov
- Department of Gynecology with Center of Oncological Surgery, Charité University Medicine, Campus Virchow-Klinikum, Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - E I Braicu
- Department of Gynecology with Center of Oncological Surgery, Charité University Medicine, Campus Virchow-Klinikum, Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - M David
- Department of Gynecology with Center of Oncological Surgery, Charité University Medicine, Campus Virchow-Klinikum, Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - J Blohmer
- Department of Gynecology and Breast Care Center, Charité University Medicine, Charité Campus Mitte, Berlin, Germany
| | - G Inci
- Department of Gynecology with Center of Oncological Surgery, Charité University Medicine, Campus Virchow-Klinikum, Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - U Torsten
- Department of Gynecology, Vivantes Klinikum Neukölln Berlin, Berlin, Germany
| | - G Oskay-Özcelik
- Gynecological Oncology Medical Practice Berlin Spandau, Berlin, Germany
| | - I Blau
- Medical Care Center Evangelisches Waldkrankenhaus am Standort Pankow, Berlin, Germany
| | - N Fersis
- Helios Klinikum Duisburg, Duisburg, Germany
| | - A Holzgreve
- Vivantes Netzwerk für Gesundheit GmbH, Berlin, Germany
| | - E Keil
- Klinik Oranienburg, Oberhavel Kliniken GmbH, Oranienburg, Germany
| | - M Keller
- North-Eastern-German Society of Gynecological Oncology, Oranienburg, Germany
| | - U Keilholz
- Charité Comprehensive Cancer Center, Charité University Medicine, Berlin, Germany
| | - J Sehouli
- Department of Gynecology with Center of Oncological Surgery, Charité University Medicine, Campus Virchow-Klinikum, Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.
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Pasternak J, Obermayr M, Schepelmann J, Sternberg J, Czogalla B, Burges A, Hennings A, Wallwiener M, Kommoss S, Brucker S, Wölber L, Boschetti E, Chekerov R, Pietzner K, Sehouli J. Fertility-preserving treatment of stage IA, well-differentiated endometrial carcinoma (EC) or atypical complex hyperplasia (ACH) in young women with hysteroscopic resection and high-dose progesterone therapy. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1718168] [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 Pasternak
- Universitätsklinik Tübingen, Department für Frauengesundheit
| | | | | | | | - B Czogalla
- Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe, LMU
| | - A Burges
- Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe, LMU
| | - A Hennings
- Universitätsklinik Heidelberg, Klinik für Frauenheilkunde und Geburtshilfe
| | - M Wallwiener
- Universitätsklinik Heidelberg, Klinik für Frauenheilkunde und Geburtshilfe
| | - S Kommoss
- Universitätsklinik Tübingen, Department für Frauengesundheit
| | - S.Y Brucker
- Universitätsklinik Tübingen, Department für Frauengesundheit
| | - L Wölber
- Universitätsklinik Hamburg-Eppendorf, Klinik und Poliklinik für Gynäkologie
| | - E Boschetti
- Universitätsmedizin Berlin, Klinik für Gynäkologie mit Zentrum für onkologische Chirurgie Charité Campus Virchow-Klinikum
| | - R Chekerov
- Universitätsmedizin Berlin, Klinik für Gynäkologie mit Zentrum für onkologische Chirurgie Charité Campus Virchow-Klinikum
| | - K Pietzner
- Universitätsmedizin Berlin, Klinik für Gynäkologie mit Zentrum für onkologische Chirurgie Charité Campus Virchow-Klinikum
| | - J Sehouli
- Universitätsmedizin Berlin, Klinik für Gynäkologie mit Zentrum für onkologische Chirurgie Charité Campus Virchow-Klinikum
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Colombo N, Gadducci A, Sehouli J, Biagioli E, Nyvang GB, Riniker S, Montes A, Ottevanger N, Zeimet A, Vergote I, Funari G, Baldoni A, Tognon G, De Censi A, Galaz CC, Chekerov R, Maenpaa J, Rulli E, Fossati R, Poveda A. LBA30 INOVATYON study: Randomized phase III international study comparing trabectedin/PLD followed by platinum at progression vs carboplatin/PLD in patients with recurrent ovarian cancer progressing within 6-12 months after last platinum line. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.2260] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Oskay-Özcelik G, Alavi S, Richter R, Keller M, Chekerov R, Cecere SC, Cormio G, Joly F, Kurtz JE, du Bois A, Maciejewski M, Jedryka M, Vergote I, Van Nieuwenhuysen E, Casado A, Mendiola C, Achimas-Cadariu P, Vlad C, Reimer D, Zeimet AG, Friedlander M, Sehouli J. Expression III: patients' expectations and preferences regarding physician-patient relationship and clinical management-results of the international NOGGO/ENGOT-ov4-GCIG study in 1830 ovarian cancer patients from European countries. Ann Oncol 2019; 29:910-916. [PMID: 29415128 DOI: 10.1093/annonc/mdy037] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Backround The primary aim of this study was to investigate information needs and treatment preferences of patients with ovarian cancer, focusing especially on physician-patient relationship and treatment. Patients and methods A questionnaire was developed based on the experiences of the national German survey 'Expression II', and was provided to patients with ovarian cancer either at initial diagnosis or with recurrent disease via Internet (online-version) or as print-out-version. Results From December 2009 to October 2012, a total of 1830 patients with ovarian cancer from eight European countries (Austria, Belgium, France, Germany, Italy, Poland, Romania, Spain) participated, 902 (49.3%) after initial diagnosis and 731 (39.9%) with recurrent ovarian cancer. The median age was 58 years (range 17-89). Nearly all patients (96.2%) had experienced upfront surgery followed by first-line chemotherapy (91.8%). The majority of patients were satisfied with the completeness and comprehensibility of the explanation about the diagnosis and treatment options. The three most important aspects, identified by patients to improve the treatment for ovarian cancer included: 'the therapy should not induce alopecia' (42%), 'there must be more done to counter fatigue' (34.5%) and 'the therapy should be more effective' (29.7%). Out of 659 (36%) patients, who were offered participation in a clinical trial, 476 (26%) were included. Conclusion This study underlines the high need of patients with ovarian cancer for all details concerning treatment options irrespective of their cultural background, the stage of disease and the patient's age. Increased information requirements regarding potential side effects and treatment alternatives were recorded. Besides the need for more effective therapy, alopecia and fatigue are the most important side effects of concern to patients.
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Affiliation(s)
- G Oskay-Özcelik
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Department of Gynecology, Charité European Competence Center for Ovarian Cancer, Berlin; North-Eastern German Society of Gynecological Oncology (NOGGO), Berlin, Germany
| | - S Alavi
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Department of Gynecology, Charité European Competence Center for Ovarian Cancer, Berlin; North-Eastern German Society of Gynecological Oncology (NOGGO), Berlin, Germany
| | - R Richter
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Department of Gynecology, Charité European Competence Center for Ovarian Cancer, Berlin
| | - M Keller
- North-Eastern German Society of Gynecological Oncology (NOGGO), Berlin, Germany
| | - R Chekerov
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Department of Gynecology, Charité European Competence Center for Ovarian Cancer, Berlin; North-Eastern German Society of Gynecological Oncology (NOGGO), Berlin, Germany
| | - S C Cecere
- Division of Medical Oncolog, Department of Uro-Gynaecological Oncology, Istituto Nazionale Tumori IRCCS "Fondazione G. Pascale", Naples, Italy
| | - G Cormio
- Department of Biomedical Science and Human Oncolog, Obstetrics and Gynecology Unit, University of Bari, Bari, Italy
| | - F Joly
- Department of Medical Oncolog, Centre Francois Baclesse, Universite Basse Normandie, Caen, France
| | - J E Kurtz
- Oncology and Hematology, Hôpitaux Universitaires de Strasbourg, Strasbourg
| | - A du Bois
- Deptartment of Gynecology and Gynecologic Oncology, Kliniken Essen Mitte (KEM), Essen, Germany
| | - M Maciejewski
- Dolnoslaskie Centrum onkologii/Oddzial Ginekologii Onkologicznej, Wroclaw, Poland
| | - M Jedryka
- Department of Oncology and Gynaecological Oncology Clinic, Wroclaw Medical University, Wroclaw, Poland
| | - I Vergote
- Division of Gynaecological Oncol, Leuven Cancer Institute, Department of Gynaecology and Obstetrics, Universitaire Ziekenhuizen Leuven, Katholieke Universiteit Leuven, Leuven, Belgium
| | - E Van Nieuwenhuysen
- Division of Gynaecological Oncol, Leuven Cancer Institute, Department of Gynaecology and Obstetrics, Universitaire Ziekenhuizen Leuven, Katholieke Universiteit Leuven, Leuven, Belgium
| | - A Casado
- Department of Medical Oncology, Hospital Clínico Universitario San Carlos, Madrid, Spain
| | - C Mendiola
- University Hospital 12 de Octubre, Madrid, Spain
| | - P Achimas-Cadariu
- Department of Surgery, The Oncology Institute Ion Chiricuţă, Cluj-Napoca, Romania; Department of Surgery and Gynecologic Oncology, Iuliu Hațieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - C Vlad
- Department of Surgery, The Oncology Institute Ion Chiricuţă, Cluj-Napoca, Romania; Department of Surgery and Gynecologic Oncology, Iuliu Hațieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - D Reimer
- Department of Obstetrics and Gynecology, Medical University of Innsbruck, Innsbruck, Austria
| | - A G Zeimet
- Department of Obstetrics and Gynecology, Medical University of Innsbruck, Innsbruck, Austria
| | - M Friedlander
- Prince of Wales Clinical School, University of New South Wales, Sydney, Australia
| | - J Sehouli
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Department of Gynecology, Charité European Competence Center for Ovarian Cancer, Berlin; North-Eastern German Society of Gynecological Oncology (NOGGO), Berlin, Germany.
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Canaz E, Grabowski J, Richter R, Braicu E, Chekerov R, Sehouli J. Survival and prognostic factors in patients with recurrent low-grade epithelial ovarian cancer: An analysis of five prospective phase II/III trials of NOGGO metadata base. Gynecol Oncol 2019; 154:539-546. [DOI: 10.1016/j.ygyno.2019.06.014] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 06/03/2019] [Accepted: 06/13/2019] [Indexed: 12/18/2022]
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Woopen H, Richter R, Inci G, Alavi S, Chekerov R, Sehouli J. The prognostic and predictive role of pain before systemic chemotherapy in recurrent ovarian cancer: an individual participant data meta-analysis of the North-Eastern German Society of Gynecological Oncology (NOGGO) of 1226 patients. Support Care Cancer 2019; 28:1997-2003. [PMID: 31385100 DOI: 10.1007/s00520-019-05000-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Accepted: 07/16/2019] [Indexed: 11/25/2022]
Abstract
BACKGROUND Aim of this study was to analyze the impact of pain on quality of life and survival in recurrent OC patients. METHODS Raw data including the QLQ-C30 questionnaire from three phase II/III trials ("Topotecan phase III," "Hector," and "TRIAS") conducted by the North-Eastern German Society of Gynecological Oncology (NOGGO) were synthesized and analyzed using logistic and Cox regression analyses. RESULTS Data on pain was available for 952 patients out of 1226. Moderate to severe pain, which was defined as pain ≥ 50 in the QLQ-C30 symptom scale, was experienced by more than one-third of patients (36.6%). A total of 31% were taking non-opioid pain medication and 16% opioids. Median age at randomization was 61 years (range 25-84). Most patients (84.7%) were diagnosed in FIGO III/IV. Pain was independent from age, FIGO stage, grading, amount of recurrences, and chemotherapy-free interval. ECOG was significantly worse in patients with pain (p < 0.001). Fatigue, nausea/vomiting, sleeping disorders, and abdominal symptoms such as loss of appetite, diarrhea, and constipation were more frequently found in patients with pain (all p < 0.001). Quality of life was significantly diminished (p < 0.001). Pain was also an independent marker for overall survival (OS). Median OS was 18.2 months in patients with pain compared with 22.0 months in patients without pain (p = 0.013, HR 1.25, 95% confidence interval 1.05-1.48). OS was shorter in patients with pain and without pain medication compared with those on sufficient pain medication, whereas OS was mostly decreased in patients having pain despite pain medication (18.5, 19.6, and 15.0 months respectively; p = 0.026). Progression-free survival and prior treatment discontinuation were not associated with pain. CONCLUSION Best supportive care including sufficient pain medication should be delivered as early as possible because effective pain management is crucial for both quality of life and overall survival in patients with recurrent ovarian cancer.
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Affiliation(s)
- H Woopen
- European Competence Center for Ovarian Cancer (EKZE), Department of Gynecology with Center for Oncological Surgery, Charité - University Medicine of Berlin, Campus Virchow Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany.
| | - R Richter
- European Competence Center for Ovarian Cancer (EKZE), Department of Gynecology with Center for Oncological Surgery, Charité - University Medicine of Berlin, Campus Virchow Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany
| | - G Inci
- European Competence Center for Ovarian Cancer (EKZE), Department of Gynecology with Center for Oncological Surgery, Charité - University Medicine of Berlin, Campus Virchow Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany
| | - S Alavi
- European Competence Center for Ovarian Cancer (EKZE), Department of Gynecology with Center for Oncological Surgery, Charité - University Medicine of Berlin, Campus Virchow Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany
| | - R Chekerov
- European Competence Center for Ovarian Cancer (EKZE), Department of Gynecology with Center for Oncological Surgery, Charité - University Medicine of Berlin, Campus Virchow Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany
| | - J Sehouli
- European Competence Center for Ovarian Cancer (EKZE), Department of Gynecology with Center for Oncological Surgery, Charité - University Medicine of Berlin, Campus Virchow Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany
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Woopen H, Richter R, Chekerov R, Inci G, Alavi S, Grabowski JP, Sehouli J. Prognostic role of chemotherapy-induced nausea and vomiting in recurrent ovarian cancer patients: results of an individual participant data meta-analysis in 1213. Support Care Cancer 2019; 28:73-78. [DOI: 10.1007/s00520-019-04778-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Accepted: 03/25/2019] [Indexed: 01/01/2023]
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9
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Altmann J, Alavi S, Pietzner K, Chekerov R, Döllinger F, Sehouli J. Fallbericht eines dedifferenzierten Liposarkoms mit den klinischen Zeichen eines Ovarialkarzinoms sowie eine Zusammenfassung der Literatur. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1670993] [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 Altmann
- Charité Universitätsmedizin, Geburtshilfe, Berlin, Deutschland
| | - S Alavi
- Charité Universitätsmedizin, Berlin, Deutschland
| | - K Pietzner
- Charité Universitätsmedizin, Berlin, Deutschland
| | - R Chekerov
- Charité Universitätsmedizin, Berlin, Deutschland
| | - F Döllinger
- Charité Universitätsmedizin, Radiologie, Berlin, Deutschland
| | - J Sehouli
- Charité Universitätsmedizin, Berlin, Deutschland
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Alavi S, Harter P, Richter R, Keller M, Oskay-Özcelik G, Mustea A, Schmalfeldt B, Wimberger P, Trillsch F, Mahner S, Klar M, Wagner U, Chekerov R, du Bois A, Sehouli J. MONITOR VII – Behandlungsstrategie beim Low-grade Ovarialkarzinom. Eine deutschlandweite Umfrage der Charité – Berlin und Kliniken Essen Mitte mit Unterstützung der NOGGO und AGO. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1670991] [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 Alavi
- Charité – Universitätsmedizin Berlin, Klinik für Gynäkologie mit Zentrum für onkologische Chirurgie, Berlin, Deutschland
| | - P Harter
- Kliniken Essen Mitte, Essen, Deutschland
| | - R Richter
- Charité – Universitätsmedizin Berlin, Klinik für Gynäkologie mit Zentrum für onkologische Chirurgie, Berlin, Deutschland
| | - M Keller
- Nord-Ostdeutsche Gesellschaft für Gynäkologische Onkologie, Berlin, Deutschland
| | - G Oskay-Özcelik
- Charité – Universitätsmedizin Berlin, Klinik für Gynäkologie mit Zentrum für onkologische Chirurgie, Berlin, Deutschland
| | - A Mustea
- Universitätsmedizin Greifswald, Greifswald, Deutschland
| | - B Schmalfeldt
- Universitätsklinikum Eppendorf, Hamburg, Deutschland
| | - P Wimberger
- Universitätsklinikum Carl Gustav Carus Dresden, Dresden, Deutschland
| | - F Trillsch
- Klinikum der Ludwig-Maximilians-Universität München, München, Deutschland
| | - S Mahner
- Klinikum der Ludwig-Maximilians-Universität München, München, Deutschland
| | - M Klar
- Universitätsklinik Freiburg, Freiburg, Deutschland
| | - U Wagner
- Philipps-Universität Marburg, Marburg, Deutschland
| | - R Chekerov
- Charité – Universitätsmedizin Berlin, Klinik für Gynäkologie mit Zentrum für onkologische Chirurgie, Berlin, Deutschland
| | - A du Bois
- Kliniken Essen Mitte, Essen, Deutschland
| | - J Sehouli
- Charité – Universitätsmedizin Berlin, Klinik für Gynäkologie mit Zentrum für onkologische Chirurgie, Berlin, Deutschland
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Dröge LA, Eckes L, Osman S, Pasternak J, Jordan J, Harter P, Mustea A, Muallem MZ, Wimberger P, Mahner S, Kurzeder C, Hasenburg A, Chekerov R, Denschlag D, Sehouli J. Management von Patientinnen mit gynäkologischem Sarkom – Eine Umfrage zur Behandlungspraxis der betreuenden GynäkologInnen im Rahmen der REGSA-Studie (Deutsches gynäkoonkologisches Sarkomregister) – MONITOR IX. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671009] [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)
- LA Dröge
- Universitätsmedizin Charité Berlin Campus Virchow Klinikum, Gynäkologie, Berlin, Deutschland
| | - L Eckes
- Universitätsmedizin Charité Berlin Campus Virchow Klinikum, Gynäkologie, Berlin, Deutschland
| | - S Osman
- Universitätsmedizin Charité Berlin Campus Virchow Klinikum, Gynäkologie, Berlin, Deutschland
| | - J Pasternak
- Universitätsklinik Tübingen, Gynäkologie, Tübingen, Deutschland
| | - J Jordan
- NOGGO e.V., Gynäkologische Onkologie, Berlin, Deutschland
| | - P Harter
- Kliniken Essen Mitte, Gynäkologie und Gynäkoonkologie, Essen, Deutschland
| | - A Mustea
- Universitätsmedizin Greifswald, Gynäkologie, Greifswald, Deutschland
| | - MZ Muallem
- Universitätsmedizin Charité Berlin Campus Virchow Klinikum, Gynäkologie, Berlin, Deutschland
| | - P Wimberger
- Uni.-Klinikum Carl Gustav Carus, Gynäkologie und Onkologie, Dresden, Deutschland
| | - S Mahner
- Universität München, Gynäkologie und Geburtshilfe, München, Deutschland
| | - C Kurzeder
- Universitätsspital Basel, Gynäkologie, Basel, Schweiz
| | - A Hasenburg
- Universität Mainz, Gynäkologie und Geburtshilfe, Mainz, Deutschland
| | - R Chekerov
- Universitätsmedizin Charité Berlin Campus Virchow Klinikum, Gynäkologie, Berlin, Deutschland
| | - D Denschlag
- Hochtaunus-Kliniken, Gynäkologie und Geburtshilfe, Bad Homburg, Deutschland
| | - J Sehouli
- Universitätsmedizin Charité Berlin Campus Virchow Klinikum, Gynäkologie, Berlin, Deutschland
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Dröge LA, Alavi S, Chekerov R, Muallem MZ, Pietzner K, Sehouli J. Patientinnen mit gynäkologischem Sarkom: Charakteristika aus der Online-Tumorkonferenz für seltene Tumoren. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671011] [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)
- LA Dröge
- Universitätsmedizin Charité Berlin Campus Virchow Klinikum, Gynäkologie, Berlin, Deutschland
| | - S Alavi
- Universitätsmedizin Charité Berlin Campus Virchow Klinikum, Gynäkologie, Berlin, Deutschland
| | - R Chekerov
- Universitätsmedizin Charité Berlin Campus Virchow Klinikum, Gynäkologie, Berlin, Deutschland
| | - MZ Muallem
- Universitätsmedizin Charité Berlin Campus Virchow Klinikum, Gynäkologie, Berlin, Deutschland
| | - K Pietzner
- Universitätsmedizin Charité Berlin Campus Virchow Klinikum, Gynäkologie, Berlin, Deutschland
| | - J Sehouli
- Universitätsmedizin Charité Berlin Campus Virchow Klinikum, Gynäkologie, Berlin, Deutschland
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13
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Alavi S, Chinczewski L, Taube ET, Feldhaus FW, Dröge LA, Chekerov R, Pietzner K, Muallem MZ, Sehouli J. Angiosarkom des weiblichen Genitaltraktes – Fallserie eines äußerst seltenen, aggressiven und vielgesichtigen Tumors mit systematischem Review. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1670992] [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 Alavi
- Charité – Universitätsmedizin Berlin, Klinik für Gynäkologie mit Zentrum für onkologische Chirurgie, Berlin, Deutschland
| | - L Chinczewski
- Charité – Universitätsmedizin Berlin, Klinik für Gynäkologie mit Zentrum für onkologische Chirurgie, Berlin, Deutschland
| | - ET Taube
- Charité – Universitätsmedizin Berlin, Institut für Pathologie, Berlin, Deutschland
| | - FW Feldhaus
- Charité – Universitätsmedizin Berlin, Institut für Radiologie, Berlin, Deutschland
| | - LA Dröge
- Charité – Universitätsmedizin Berlin, Klinik für Gynäkologie mit Zentrum für onkologische Chirurgie, Berlin, Deutschland
| | - R Chekerov
- Charité – Universitätsmedizin Berlin, Klinik für Gynäkologie mit Zentrum für onkologische Chirurgie, Berlin, Deutschland
| | - K Pietzner
- Charité – Universitätsmedizin Berlin, Klinik für Gynäkologie mit Zentrum für onkologische Chirurgie, Berlin, Deutschland
| | - MZ Muallem
- Charité – Universitätsmedizin Berlin, Klinik für Gynäkologie mit Zentrum für onkologische Chirurgie, Berlin, Deutschland
| | - J Sehouli
- Charité – Universitätsmedizin Berlin, Klinik für Gynäkologie mit Zentrum für onkologische Chirurgie, Berlin, Deutschland
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14
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Dröge LA, Alavi S, Chekerov R, Muallem MZ, Pietzner K, Seifert G, Sehouli J. Patientinnen mit Keimstrang-Stroma-Tumor: Charakteristika aus der Online-Tumorkonferenz für seltene Tumoren. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671010] [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)
- LA Dröge
- Universitätsmedizin Charité, Gynäkologie, Berlin, Deutschland
| | - S Alavi
- Universitätsmedizin Charité, Gynäkologie, Berlin, Deutschland
| | - R Chekerov
- Universitätsmedizin Charité, Gynäkologie, Berlin, Deutschland
| | - MZ Muallem
- Universitätsmedizin Charité, Gynäkologie, Berlin, Deutschland
| | - K Pietzner
- Universitätsmedizin Charité, Gynäkologie, Berlin, Deutschland
| | - G Seifert
- Universitätsmedizin Charité, Klinik für Pädiatrie, Kinderonkologie, Berlin, Deutschland
| | - J Sehouli
- Universitätsmedizin Charité, Gynäkologie, Berlin, Deutschland
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Alavi S, Harter P, Richter R, Keller M, Oskay-Özcelik G, Mustea A, Schmalfeldt B, Wimberger P, Trillsch F, Mahner S, Klar M, Wagner U, Chekerov R, du Bois A, Sehouli J. MONITOR VII: Treatment strategies of low grade ovarian carcinomas – A German survey of the Charité – Berlin and Kliniken Essen Mitte with support of the study groups NOGGO and AGO. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy285.202] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Dröge LA, Alavi S, Taube ET, Muallem MZ, Chekerov R, Pietzner K, Sehouli J. Peritoneal metastasiertes High-grade-Stromasarkom – Eine Kasuistik. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671534] [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)
- LA Dröge
- Universitätsmedizin Charité Campus Virchow Klinikum, Gynäkologie, Berlin, Deutschland
| | - S Alavi
- Universitätsmedizin Charité Campus Virchow Klinikum, Gynäkologie, Berlin, Deutschland
| | - ET Taube
- Universitätsmedizin Berlin Charité, Campus Virchow Klinikum, Institut für Pathologie, Berlin, Deutschland
| | - MZ Muallem
- Universitätsmedizin Charité Campus Virchow Klinikum, Gynäkologie, Berlin, Deutschland
| | - R Chekerov
- Universitätsmedizin Charité Campus Virchow Klinikum, Gynäkologie, Berlin, Deutschland
| | - K Pietzner
- Universitätsmedizin Charité Campus Virchow Klinikum, Gynäkologie, Berlin, Deutschland
| | - J Sehouli
- Universitätsmedizin Charité Campus Virchow Klinikum, Gynäkologie, Berlin, Deutschland
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17
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Braicu E, Torsten U, Richter R, Beteta C, Boneß-Zaloume J, Dimitrova D, Koch E, Chen F, Chekerov R, Hasenbein K, Sehouli J. HE4 is the marker of choice in discriminating endometriosis from ovarian cancer in pelvic mass patients: Sub-analysis of a prospective multicentric study. Gynecol Oncol 2018. [DOI: 10.1016/j.ygyno.2018.04.547] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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18
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Jung S, Sehouli J, Chekerov R, Kluschke F, Patzelt A, Fuss H, Knorr F, Lademann J. Prevention of palmoplantar erythrodysesthesia in patients treated with pegylated liposomal doxorubicin (Caelyx®). Support Care Cancer 2017; 25:3545-3549. [PMID: 28653108 DOI: 10.1007/s00520-017-3781-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Accepted: 06/07/2017] [Indexed: 12/30/2022]
Abstract
PURPOSE Palmoplantar erythrodysesthesia (PPE) is one of the most frequent side effects during systemic treatment with pegylated liposomal doxorubicin (PLD, Caelyx®). PPE lesions show a range of symptoms, from numbness to painful erosions, and can have a major impact on the quality of life in affected patients. Previously, a possible pathomechanism of PPE was found in doxorubicin-treated patients based on radical formation in the skin. Here, a preventive strategy using a topically applied ointment with a high radical protection factor was investigated. METHODS In this randomized placebo-controlled double-blind study the antioxidant-containing ointment was compared with a placebo ointment regarding PPE grade III occurrence, overall PPE grade I-III occurrence and PPE severity in PLD patients. The verum or placebo cream was topically applied for a period of 16 weeks, starting 3 days prior to the first cycle of chemotherapy. Clinical evaluations were carried out by a dermatologist prior to the first cycle of chemotherapy and every 4 weeks for the duration of 16 weeks. RESULTS Thirty-two patients were enrolled in total, of which 17 (66%) completed the study. No PPE grade III was found in the verum group, while five out of seven patients (71%) had to be unblinded in the placebo arm due to PPE grade III (p = 0.003). General PPE occurrence of all grades was 60% under verum and 86% under placebo treatment. CONCLUSIONS The preventive application of an antioxidant-containing ointment was shown to be significantly more effective in the prevention of PPE grade III compared to placebo treatment.
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Affiliation(s)
- S Jung
- Department of Dermatology, Venerology and Allergology, Center of Experimental and Applied Cutaneous Physiology, Charité - Universitätsmedizin Berlin, Berlin, Germany.
| | - J Sehouli
- Department of Gynaecology and Obstetrics, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - R Chekerov
- Department of Gynaecology and Obstetrics, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - F Kluschke
- Department of Dermatology, Venerology and Allergology, Center of Experimental and Applied Cutaneous Physiology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - A Patzelt
- Department of Dermatology, Venerology and Allergology, Center of Experimental and Applied Cutaneous Physiology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - H Fuss
- Department of Hematology, Oncology and Palliative Care, Helios Klinikum Bad Saarow, Bad Saarow, Germany
| | - F Knorr
- Department of Dermatology, Venerology and Allergology, Center of Experimental and Applied Cutaneous Physiology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - J Lademann
- Department of Dermatology, Venerology and Allergology, Center of Experimental and Applied Cutaneous Physiology, Charité - Universitätsmedizin Berlin, Berlin, Germany
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Sehouli J, Chekerov R, Reinthaller A, Richter R, Gonzalez-Martin A, Harter P, Woopen H, Petru E, Hanker L, Keil E, Wimberger P, Klare P, Kurzeder C, Hilpert F, Belau A, Zeimet A, Bover-Barcelo I, Canzler U, Mahner S, Meier W. Topotecan plus carboplatin versus standard therapy with paclitaxel plus carboplatin (PC) or gemcitabine plus carboplatin (GC) or pegylated liposomal doxorubicin plus carboplatin (PLDC): a randomized phase III trial of the NOGGO-AGO-Study Group-AGO Austria and GEICO-ENGOT-GCIG intergroup study (HECTOR). Ann Oncol 2016; 27:2236-2241. [DOI: 10.1093/annonc/mdw418] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Revised: 07/20/2016] [Accepted: 08/23/2016] [Indexed: 11/13/2022] Open
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20
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Alavi S, Oskay-Özcelik G, Richter R, Chekerov R, Neubert S, Mallmann P, Lorenz R, Gebauer G, Untch M, Kanzler U, Schubert R, Richter B, Beck A, Sehouli J. Expression III: Erwartungen und Präferenzen von Patientinnen mit Ovarialkarzinom. Eine Umfrage an 585 Patientinnen (NOGGO/Subanalyse der ENGOT ov4-Studie). Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1593018] [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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21
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Rohr I, Sehouli J, En-Nia A, Heinrich M, Richter R, Chekerov R, Dechend R, Heidecke H, Dragun D, Schäfer R, Gorny X, Lindquist J, Brandt S, Braicu E, Mertens P. Y-box protein-1/p18 as novel serum marker for ovarian cancer diagnosis: A study by the Tumor Bank Ovarian Cancer (TOC). Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1593015] [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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22
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Dimitrova D, Naghavi B, Neumann K, David M, Chekerov R, Braicu EI, Torsten U, Kronenberger C, Oskay-Özcelik G, Blau I, Keilholz U, Sehouli J. Erste Ergebnisse der Expression V Studie – Berliner Umfrage zu Erwartungen und Wünsche von Patientinnen mit und ohne Migrationshintergrund und gynäkologische Malignome. Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1571403] [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: 10/22/2022] Open
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23
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Dimitrova D, Naghavi B, Neumann K, David M, Braicu EI, Chekerov R, Torsten U, Kronenberger C, Oskay-Özcelik G, Blau I, Yüksel E, Blohmer JU, Keilholz U, Sehouli J. Interimsanalyse der multizentrischen NOGGO Studie – Expression V – Umfrage zu den Erwartungen und Wünschen von Patientinnen mit gynäkologischen Malignomen und mit und ohne Migrationshintergrund. Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1571369] [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: 10/22/2022] Open
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Sehouli J, Braicu EI, Chekerov R. PARP Inhibitors for Recurrent Ovarian Carcinoma: Current Treatment Options and Future Perspectives. Geburtshilfe Frauenheilkd 2016; 76:164-169. [PMID: 26941449 DOI: 10.1055/s-0035-1558185] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
More than simply a promising management option, PARP inhibitors can be regarded as a milestone in the development of personalised treatment of recurrent ovarian carcinoma. Their mechanism of action, known as "synthetic lethality", is dependent on functional differences of the DNA repair mechanisms of healthy cells and tumour cells; cells that repair DNA damage less efficiently are particularly sensitive to PARP inhibitors. Olaparib, licensed for use this year, is the best-studied PARP inhibitor used for treatment of high-grade serous ovarian carcinoma (HGSC). The efficacy of PARP inhibitors appears to be increased when used in combination with other treatments.
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Affiliation(s)
- J Sehouli
- Universitätsklinikum Berlin Charité, Klinik für Gynäkologie, Charté Comprehensive Cancer Center (CCCC), Berlin
| | - E I Braicu
- Universitätsklinikum Berlin Charité, Campus Virchow-Klinikum, Klinik für Gynäkologie, Charté Comprehensive Cancer Center (CCCC), Berlin
| | - R Chekerov
- Universitätsklinikum Berlin Charité, Campus Virchow-Klinikum, Klinik für Gynäkologie, Charté Comprehensive Cancer Center (CCCC), Berlin
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25
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Woopen H, Richter R, Ismaeel F, Chekerov R, Roots I, Siepmann T, Sehouli J. The influence of polypharmacy on grade III/IV toxicity, prior discontinuation of chemotherapy and overall survival in ovarian cancer. Gynecol Oncol 2016; 140:554-8. [PMID: 26790772 DOI: 10.1016/j.ygyno.2016.01.012] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2015] [Revised: 01/07/2016] [Accepted: 01/09/2016] [Indexed: 11/26/2022]
Abstract
BACKGROUND Ovarian cancer is mostly diagnosed in the elderly woman who is likely to have comorbid disease and to take several comedications on a regular basis. Aim of this study was to evaluate the influence of polypharmacy on grade III/IV toxicity, prior discontinuation of chemotherapy and survival. PATIENTS AND METHODS In this individual participant data meta-analysis the original data of three phase II/III studies of the North-Eastern German Society of Gynecological Oncology (NOGGO) were analyzed using multivariate logistic and Cox regression. RESULTS Overall, 1213 patients with recurrent ovarian cancer were included in these analyses. An increasing amount of medication was associated with overall grade III/IV toxicity (p<0.001; OR 1.120), and hematological (p<0.001; OR 1.056) and non-hematological (p<0.001; OR 1.134) toxicities. Prior discontinuation of chemotherapy was not influenced by an increasing amount of medication (p=0.196). There was no association of polypharmacy with overall survival (p=0.068). CONCLUSION As polypharmacy does not influence survival ovarian cancer patients taking several comedications may be included in clinical trials and should not be deprived of adequate cancer treatment. However, a thorough monitoring is mandatory due to the increased risk of toxicities.
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Affiliation(s)
- H Woopen
- European Competence Center for Ovarian Cancer (EKZE), Department of Gynecology, Charité - University Medicine of Berlin, Campus Virchow Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany; Dresden International University, Division of Health Care Sciences, Center for Clinical Research and Management Education, Freiberger Str. 37, 01067 Dresden, Germany.
| | - R Richter
- European Competence Center for Ovarian Cancer (EKZE), Department of Gynecology, Charité - University Medicine of Berlin, Campus Virchow Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany
| | - F Ismaeel
- European Competence Center for Ovarian Cancer (EKZE), Department of Gynecology, Charité - University Medicine of Berlin, Campus Virchow Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany
| | - R Chekerov
- European Competence Center for Ovarian Cancer (EKZE), Department of Gynecology, Charité - University Medicine of Berlin, Campus Virchow Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany
| | - I Roots
- Institute of Clinical Pharmacology and Toxicology, Charité - University Medicine Berlin, Campus Mitte, Charitéplatz 1, 10117, Berlin, Germany
| | - T Siepmann
- Dresden International University, Division of Health Care Sciences, Center for Clinical Research and Management Education, Freiberger Str. 37, 01067 Dresden, Germany
| | - J Sehouli
- European Competence Center for Ovarian Cancer (EKZE), Department of Gynecology, Charité - University Medicine of Berlin, Campus Virchow Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany.
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26
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Jung S, Sehouli J, Chekerov R, Patzelt A, Knorr F, Lademann J. Aktuelle Entwicklungen in der Prävention und Therapie des Hand- und Fußsyndroms. Akt Dermatol 2015. [DOI: 10.1055/s-0034-1377790] [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]
Affiliation(s)
- S. Jung
- Klinik für Dermatologie, Venerologie und Allergologie, Center of Experimental and Applied Cutaneous Physiology, Charité – Universitätsmedizin Berlin
| | - J. Sehouli
- Klinik für Gynäkologie und Geburtshilfe, Charité – Universitätsmedizin Berlin
| | - R. Chekerov
- Klinik für Gynäkologie und Geburtshilfe, Charité – Universitätsmedizin Berlin
| | - A. Patzelt
- Klinik für Dermatologie, Venerologie und Allergologie, Center of Experimental and Applied Cutaneous Physiology, Charité – Universitätsmedizin Berlin
| | - F. Knorr
- Klinik für Dermatologie, Venerologie und Allergologie, Center of Experimental and Applied Cutaneous Physiology, Charité – Universitätsmedizin Berlin
| | - J. Lademann
- Klinik für Dermatologie, Venerologie und Allergologie, Center of Experimental and Applied Cutaneous Physiology, Charité – Universitätsmedizin Berlin
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27
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Sehouli J, Reinthaller A, Marth C, Reimer D, Reimer T, Stummvoll W, Angleitner-Boubenizek L, Brandt B, Chekerov R. Intra- and postoperative catumaxomab in patients with epithelial ovarian cancer: safety and two-year efficacy results from a multicentre, single-arm, phase II study. Br J Cancer 2014; 111:1519-25. [PMID: 25225907 PMCID: PMC4200087 DOI: 10.1038/bjc.2014.443] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2013] [Revised: 06/25/2014] [Accepted: 07/13/2014] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND This is the first study investigating the safety and efficacy of the trifunctional antibody catumaxomab administered i.p. at the end of cytoreductive surgery and postoperatively prior to standard chemotherapy in patients with primary epithelial ovarian cancer (EOC). METHODS Patients received i.p. catumaxomab 10 μg intraoperatively and 10, 20, 50 and 150 μg on days 7, 10, 13 and 16, respectively, postoperatively. After the study, patients received standard chemotherapy and were followed for 23 months. The primary endpoint was the rate of postoperative complications. RESULTS Forty-one patients entered the study and were evaluable for safety and 34 were alive at 24 months. Complete tumour resection rate was 68%. Postoperative complications were observed in 51%, the most common anastomotic leakage (7%) and wound infections (5%). The most common catumaxomab-related adverse events were abdominal pain, nausea, vomiting and pyrexia. Thirty-nine percent discontinued catumaxomab therapy, and 98% received chemotherapy post study. Kaplan-Meier estimates of disease-free and overall survival after 24 months were 56% and 85%, respectively. CONCLUSIONS Intra- and close postoperative catumaxomab seems feasible, but efficacy and safety were limited by postsurgical complications. In the future prospective trials are needed to investigate the best schedule of integration of catumaxomab into current treatment strategies for EOC.
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Affiliation(s)
- J Sehouli
- 1] NOGGO, Ovarian cancer study group of the North-Eastern German Society of Gynaecological Oncology (NOGGO), Berlin, Germany [2] Department of Gynaecology, Charité University Hospital, Campus Virchow Clinic, Augustenburger Platz 1, 13353 Berlin, Germany
| | - A Reinthaller
- Department of Gynaecology and Gynecologic Oncology, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria
| | - C Marth
- Department of Obstetrics and Gynaecology, Innsbruck Medical University, Anichstraße 35, A-6020 Innsbruck, Austria
| | - D Reimer
- Department of Gynaecology, Charité University Hospital, Campus Virchow Clinic, Augustenburger Platz 1, 13353 Berlin, Germany
| | - T Reimer
- Department of Obstetrics and Gynaecology, Klinikum Suedstadt, University of Rostock, Südring 81, D-18059 Rostock, Germany
| | - W Stummvoll
- Department of Obstetrics and Gynaecology, Landesfrauenklinik Linz, Krankenhausstraße 26-30, A-4020 Linz, Austria
| | - L Angleitner-Boubenizek
- Department of Obstetrics and Gynaecology, Landesfrauenklinik Linz, Krankenhausstraße 26-30, A-4020 Linz, Austria
| | - B Brandt
- Neovii (formerly Fresenius) Biotech GmbH, Frankfurter Ring 193a, 80807 Munich, Germany
| | - R Chekerov
- Department of Gynaecology, Charité University Hospital, Campus Virchow Clinic, Augustenburger Platz 1, 13353 Berlin, Germany
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Rohr I, Zeilinger R, Heinrich M, Richter R, Concin N, Vergote I, Mahner S, Van Gorp T, Trillsch F, Cacsire-Tong D, Chekerov R, Sehouli J, Braicu EI. Role of IGF1 in primary ovarian cancer – a study of the OVCAD European Consortium. Geburtshilfe Frauenheilkd 2014. [DOI: 10.1055/s-0034-1388347] [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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Engels T, Frei C, Chekerov R, Bamberg C, Neitzel H, Henrich W, Verlohren S. Schwere Hypertonie und Proteinurie in 19+2 SSW bei Triploidie mit Plazentahypertrophie sowie alobärer Holoprosenzephalie. Geburtshilfe Frauenheilkd 2013. [DOI: 10.1055/s-0033-1347746] [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: 10/26/2022] Open
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Braicu EI, Fotopoulou C, Chekerov R, Richter R, Blohmer J, Kümmel S, Stamatian F, Yalcinkaya I, Mentze M, Lichtenegger W, Sehouli J. Role of serum concentration of VEGFR1 and TIMP2 on clinical outcome in primary cervical cancer: results of a companion protocol of the randomized, NOGGO-AGO phase III adjuvant trial of simultaneous cisplatin-based radiochemotherapy vs. carboplatin and paclitaxel containing sequential radiotherapy. Cytokine 2013; 61:755-8. [PMID: 23415672 DOI: 10.1016/j.cyto.2013.01.013] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2012] [Revised: 01/06/2013] [Accepted: 01/13/2013] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Aim of the present study was to analyze the expression-profile of IGF1, IGFBP3, sICAM1, sVCAM1, MMP2, MMP9, TIMP2, VEGFA, VEGFD, VEGFC and VEGFR1 in patients with high-risk FIGO-stage Ib-IIb cervical cancer. METHODS Serum from 68 cervical cancer patients treated within a phase-III-trial with either simultaneous cisplatin radiochemotherapy or sequential systemic carboplatin and paclitaxel followed by percutaneous irradiation was analyzed by ELISA. Both target expression and correlation with important clinicopathological factors were analyzed following standard statistic procedures. RESULTS All 68 patients underwent a primary radical hysterectomy with pelvic and/or paraaortic lymphadenectomy. 85.3% of the extirpated tumors had clear surgical margins (R0). Increased levels of VEGFR1, TIMP2 and MMP2 were significantly associated with positive surgical margins (p=0.004, p=0.018 and p=0.004, respectively). High concentration of MMP2 and TIMP2 correlated additionally with an advanced age at time of diagnosis (p=0.001 and p=0.007, respectively). For the cut-off value of 100 pg/ml, an increased VEGFR1 was significantly associated with poor overall (OS) and progression-free (PFS) survival (p=0.017 and p=0.015, respectively). A TIMP2 concentration of lower than 90 ng/ml was significantly associated with poorer OS and PFS (p=0.009 and p=0.043, respectively). In the multivariate analysis, TIMP2 expression in serum was the only independent prognostic factor for OS (p=0.032, HR=6.51, 95% CI=1.17-36.01). CONCLUSIONS Expression-profile of specific biomarkers associated with tumor invasion, cell migration and angiogenesis seems to be of prognostic value for both OS and PFS in patients undergoing surgery due to primary cervical cancer. Further analyses are warranted to allow an implementation of such markers into clinical practice.
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Affiliation(s)
- E I Braicu
- Department of Gynecology, Campus Virchow Klinikum, Charité Medical University Berlin, Augustenburger Platz 1, 13353 Berlin, Germany.
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Polterauer S, Vergote I, Concin N, Braicu I, Chekerov R, Mahner S, Woelber L, Cadron I, Van Gorp T, Zeillinger R, Cacsire Castillo-Tong D, Sehouli J. Prognostische Bedeutung des postoperativen Tumorrests bei Patientinnen mit epithelialem Ovarialkarzinom FIGO IIA-IV: Analyse der OVCAD Daten. Geburtshilfe Frauenheilkd 2012. [DOI: 10.1055/s-0032-1309228] [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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Chekerov R, Braun S, Ebert AD, Herbstreit C, Jagota A, Johannsmeyer KD, Kronenberger C, Potenberg J, Scharf JP, Richter R, Ulrich U, Sehouli J. First evaluation of the Joint Clinical Registries of the Coordinating Tumor Center of Berlin. Anticancer Res 2011; 31:2657-2660. [PMID: 21778319] [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: 05/31/2023]
Abstract
In the present study, we report the first analysis of the clinical management [corrected] of patients with primary ovarian cancer following the summarized data of the Joint Clinical Registries of the Coordinating Tumor Center of Berlin (Dachverband Tumorzentrum Berlin e.V.). All data were summarized for the period of 2005 to 2008 regarding age, histopathology, time of surgical intervention, follow-up and survival, based on 1124 provided data sets of patients with suspected ovarian tumours. We identified 946 patients with a diagnosis of primary ovarian cancer, mostly of advanced T3 tumour stage (63.7%), FIGO III and IV stage (40.6%) or grade II and III (91%) histology. The median age at time of diagnosis was 61 years (range 15 to 94 years). Most patients (n=414, 69.8%) underwent cytoreductive surgery within one month of diagnosis. The median follow-up period was 26 months; 241 patients died in the analyzed period. The calculated 3-year survival rate was 63.3%, although the median overall survival has not yet been reached. We detected positive correlation of tumour stage (p<0.001) and of FIGO stage (p<0.001) with survival, and these were evaluated as being prognostically significant. The implementation of institutional based clinical registries as part of the modern clinical management of patients with ovarian cancer is feasible and well accepted inside the gynaecological departments of Berlin.
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Affiliation(s)
- R Chekerov
- Department of Gynaecology, Charité University Hospital, Campus Virchow, Augustenburger Platz 1, 13353 Berlin, Germany.
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Schroeder JK, Kuemmel S, Pietzner K, Hector J, Sehouli J, Chekerov R. Optimizing the clinical management of gynecological and breast cancer via online tumor conferences. Anticancer Res 2011; 31:2669-2673. [PMID: 21778321] [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: 05/31/2023]
Abstract
BACKGROUND The therapy of gynecological malignancies and breast cancer requires a multimodal therapy approach based on current individualized and risk adapted state of the art therapy concepts. The aim of this online tumor conference project is to reach a broad interdisciplinary and cross-sectoral participation of specialists in order to develop high-quality therapy recommendations for complex casuistics. PATIENTS AND METHODS The concept of the interdisciplinary online tumor conference was established in 2004 at the Department of Gynecology, Charité Campus Virchow, University Hospital of Berlin to conduct online tumor board meetings of specialists in the field of gynecological cancer from different hospitals and gynecological and oncological practitioners from the outpatient sector. Following a systematic approach, patient data, relevant external clinical evidence and therapy preference are presented to the participants. An individual therapy recommendation for each patient is reached by consensus discussion. RESULTS By July 2009, 131 online tumor conferences had been performed with a total of 275 participants were developed. Per session, a median of 14 participants logged in online. Additionally 398 second opinion recommendations were performed. In an anonymous survey, carried out at the beginning of 2009, 95% of the participating physicians reported being satisfied with the information content and 50% were stimulated to seek more second opinions by the possibility of the online tumor conference. All contributors attested to a high comprehension of the developed therapy recommendations; 70% confirmed further that the conference presents an optimal possibility for fast and detailed exchange of information between disciplines and care sectors (in- and out-patient) and improves advanced educational training (81%). CONCLUSION The online tumor conference provides a time saving and high quality possibility for receiving a treatment recommendation based on the best available clinical and scientific evidence and contributes to continuously advanced training for therapists in the field of gynecological cancer.
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Affiliation(s)
- J K Schroeder
- Department of Obstetrics and Gynecology, University of Duisburg-Essen, Essen, Germany
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Oskay-Özcelik G, Richter R, Pietzner K, Hindenburg H, Sommer HL, Chekerov R, Camara O, Keil E, Einenkel J, Lichtenegger W, Sehouli J. First quality-of-life data of a sequential dose-dense regimen in advanced ovarian cancer: A multicenter phase II study of the Northeastern German Society of Gynecological Oncology. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.5071] [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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Chekerov R, Braicu EI, Richter R, Oskay-Özcelik G, Pietzner K, Fotopoulou C, Lisboa BW, Lichtenegger W, Sehouli J. Are there any molecular biologic factors which explain the poorer prognosis of elderly patients with advanced ovarian cancer? J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.e15549] [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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Pietzner K, Sehouli J, Atz J, Dettmar K, Martinius H, Spannagl R, Seimetz D, Schroeder P, Lindhofer H, Oskay-Özcelik G, Chekerov R, Braicu EI. Effect of catumaxomab on EpCAM+ tumor cells in vitro in the presence of immune effector cells from ovarian cancer patients treated with chemotherapy. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.e13043] [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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Fotopoulou C, Braicu EI, Chekerov R, Richter R, Mentze M, Pietzner K, Pop C, Camara O, Oskay-Özcelik G, Kuemmel S, Blohmer JU, Lichtenegger W, Sehouli J. Does overexpression of VEGFR and TIMP2 predict survival in primary cervical cancer (CC) patients? Results of a companion protocol of the randomized, phase III adjuvant trial of simultaneous cisplatin radiochemotherapy versus sequential carboplatin and paclitaxel followed by radiotherapy. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.e15507] [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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Braicu EI, Fotopoulou C, Richter R, Chekerov R, Pietzner K, Hall C, Lichtenegger W, Sehouli J. The role of HE4 in predicting surgical outcome in recurrent ovarian cancer (ROC). J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.e15556] [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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El Khalfaoui K, Mahner S, Richter R, Hilpert F, Lorenz R, Harter P, Klare P, Wagner UAG, Chekerov R, Sehouli J. A randomized, double-blind, placebo-controlled, multicenter phase II study to compare the efficacy and safety of sorafenib added to standard treatment with topotecan to standard treatment alone in patients with platinum-resistant recurrent ovarian cancer (TRIAS): Results of a NOGGO-AGO intergroup pilot-study. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.e15548] [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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Sehouli J, Reinthaller A, Marth C, Reimer D, Reimer T, Stummvoll W, Angleitner-Boubenizek L, Lehnert B, Marquardt M, Essing MM, Chekerov R. Intra- and post-operative catumaxomab in patients with epithelial ovarian cancer: Two-year efficacy results from a multicenter, single-arm, phase II study. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.5082] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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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41
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Chekerov R, Reinthaller A, Reimer D, Reimer T, Angleitner-Boubenizek L, Halfen M, Lindhofer H, Braicu I, Oskay-özcelik G, Sehouli J. Intraoperative immunotherapy with the trifunctional antibody catumaxomab in patients with ovarian cancer: Results from a phase II study. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.5039] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [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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Braicu EI, Zeillinger R, Vergote IB, Mahner S, Zeimet AG, Cadron I, Castillo-Tong D, Chekerov R, Brandt B, Sehouli J. Use of HE4 expression in plasma to predict operative outcome in patients with ovarian cancer (OC). J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.5022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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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Dimitrova D, Braicu EI, Richter R, Chekerov R, Oskay-özcelik G, Pietzner K, Parashkevova A, Lichtenegger W, Olek S, Sehouli J. Impact of BRCA1 gene alterations on tumor characteristics and clinical outcome in ovarian cancer (OC) patients. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.5019] [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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Oskay-Özcelik G, Chekerov R, Sommer H, Keil E, Einenkel J, Pfisterer J, Lorenz-Schlüter C, Lichtenegger W, Camara O, Sehouli J. Sequential chemotherapy with carboplatin followed by weekly paclitaxel in advanced ovarian cancer: Results of a multicenter phase II study of the northeastern German society of gynecological oncology. Gynecol Oncol 2010; 116:317-22. [DOI: 10.1016/j.ygyno.2009.09.031] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2009] [Revised: 09/19/2009] [Accepted: 09/22/2009] [Indexed: 11/28/2022]
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Chekerov R, Coumbos A, Sehouli J, Schaedel D, Oskay-Oezcelik G, Lichtenegger W, Kuehn W. Current management of borderline ovarian tumors: A multicenter survey of 323 clinics in Germany, on behalf of the North-Eastern German Society of Gynecological Oncology (NOGGO). J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.e16568] [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
e16568 Background: The aim of this survey was to analyze the standard of care in diagnostic, surgery, chemotherapy and aftercare management of patients with Borderline tumor of the ovary (BOT) in Germany. Methods: A structured questionnaire comprising different dimensions of treatment of BOT was sent to all 1,114 gynecological departments in Germany. The questionnaire could be returned anonymously. Results: The overall response rate was 29.0% (323 departments). The most departments were on secondary care (71.8%), tertiary care (23.2%) or university hospital (5.0%) level. The most clinicians performed not more than 5 BOT operations (89.2%) per year. 93.2% of the gynecological departments used additional preoperative diagnostic procedures to the classical bimanual examination and vaginal ultrasound in a case of unclear ovarian tumor: CA-125 or CEA detection (95%), CT-scan (76%), Doppler ultrasound (66%), MRI (36%), or PET-CT (1.7%) techniques. In university hospitals (87%), tertiary care (80%), secondary care (68%) and most of the general practitioners’ hospitals (64%) a regular fresh frozen section was the intraoperative diagnostic standard. For diagnosis of BOT mostly laparotomy (48%) and laparoscopy (15%) were performed, whereas 19% used a diagnostic laparoscopy, followed by laparotomy for completion in a second intervention or switch from laparoscopy to laparotomy in the primary surgical session (18%). In young women with desire to preserve fertility clinicians performed much seldom unilateral salpingo-oophorectomy (92%) and only in 53% biopsies of the contra lateral ovary and in 67% peritoneal biopsies. Generally biopsies of the contra lateral ovary were performed in 4% to 53% of all patients. Chemotherapy was the second therapy option (64%) after surgery (97%) for BOT, mostly favored in “high-risk” patients with tumor residual, micro invasion or invasive implants. Conclusions: These data demonstrate a high clinical unsureness in the clinical management of borderline tumors of the ovary. No significant financial relationships to disclose.
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Affiliation(s)
- R. Chekerov
- Charité University Hospital, Campus Virchow, Berlin, Germany; Private Praxis of Obstetrics and Gynecology, Berlin, Germany; Laser- und Medizin- Technologie GmbH, Berlin, Germany; Charité University Hospital, Campus Benjamin Franklin, Berlin, Germany
| | - A. Coumbos
- Charité University Hospital, Campus Virchow, Berlin, Germany; Private Praxis of Obstetrics and Gynecology, Berlin, Germany; Laser- und Medizin- Technologie GmbH, Berlin, Germany; Charité University Hospital, Campus Benjamin Franklin, Berlin, Germany
| | - J. Sehouli
- Charité University Hospital, Campus Virchow, Berlin, Germany; Private Praxis of Obstetrics and Gynecology, Berlin, Germany; Laser- und Medizin- Technologie GmbH, Berlin, Germany; Charité University Hospital, Campus Benjamin Franklin, Berlin, Germany
| | - D. Schaedel
- Charité University Hospital, Campus Virchow, Berlin, Germany; Private Praxis of Obstetrics and Gynecology, Berlin, Germany; Laser- und Medizin- Technologie GmbH, Berlin, Germany; Charité University Hospital, Campus Benjamin Franklin, Berlin, Germany
| | - G. Oskay-Oezcelik
- Charité University Hospital, Campus Virchow, Berlin, Germany; Private Praxis of Obstetrics and Gynecology, Berlin, Germany; Laser- und Medizin- Technologie GmbH, Berlin, Germany; Charité University Hospital, Campus Benjamin Franklin, Berlin, Germany
| | - W. Lichtenegger
- Charité University Hospital, Campus Virchow, Berlin, Germany; Private Praxis of Obstetrics and Gynecology, Berlin, Germany; Laser- und Medizin- Technologie GmbH, Berlin, Germany; Charité University Hospital, Campus Benjamin Franklin, Berlin, Germany
| | - W. Kuehn
- Charité University Hospital, Campus Virchow, Berlin, Germany; Private Praxis of Obstetrics and Gynecology, Berlin, Germany; Laser- und Medizin- Technologie GmbH, Berlin, Germany; Charité University Hospital, Campus Benjamin Franklin, Berlin, Germany
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Fotopoulou C, Karavas A, Trappe R, Chekerov R, Lichtenegger W, Sehouli J. Venous thromboembolism in recurrent ovarian cancer-patients: A systematic evaluation of the North-Eastern German Society of Gynaecologic Oncology Ovarian Cancer Study Group (NOGGO). Thromb Res 2009; 124:531-5. [PMID: 19427025 DOI: 10.1016/j.thromres.2009.03.013] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2009] [Revised: 03/30/2009] [Accepted: 03/30/2009] [Indexed: 01/01/2023]
Abstract
INTRODUCTION Systemic chemotherapy and surgery for patients with recurrent ovarian cancer (ROC) constitute a therapeutic challenge. Venous thromboembolism (VTE) seems to have a negative prognostic impact in patients with solid tumors including primary ovarian cancer in many series. Only limited contemporary data exist regarding the impact of VTE on ROC. PATIENTS AND METHODS Two large multicenter prospective controlled phase I/II-III studies on 2nd-line topotecan-based chemotherapy with platinum-sensitive or resistant ROC (N=525) were conducted on both operated and non-operative patients by the North-Eastern German Society of Gynaecologic Oncology Ovarian Cancer Study Group (NOGGO). Analysis was performed to identify incidence, predictors and prognosis of VTE. Survival analysis, univariate and Cox-regression analysis were performed to identify independent predictors of VTE, overall and progression free survival. RESULTS Thirty-seven (7%) VTE-episodes during chemotherapy were identified; 70% of them occurred within the first 2 months after initiation of chemotherapy. Ascites, as a sign of peritoneal carcinomatosis and advanced tumor disease, was identified as independent predictor of VTE. Advanced age and high BMI did not appear to affect significantly the VTE-incidence. High performance status, platinum-sensitivity, serous-papillary histology, lack of ascites and surgery appeared to positively affect survival by multivariate analysis. Overall survival and progression free survival were similar between the VTE and no-VTE patients. CONCLUSION ROC-patients appear to have the highest risk for developing VTE when ascites exists and during the first 2 months following chemotherapy initiation. In contrast to primary ovarian cancer, VTE could not be identified to affect overall survival in relapsed malignant ovarian disease.
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Affiliation(s)
- C Fotopoulou
- Department of Gynecology and Obstetrics, Charité, University Hospital, Augustenburger Platz 1, 13353 Berlin, Germany.
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Chekerov R, Oskay-Oezcelik G, Otremba B, Seipelt G, Camara O, Schmidt M, Schmalfeldt B, Lorsbach E, Sehouli J. How is the clinical practice? Pegylated liposomal doxorubicin in the therapy of patients with recurrent ovarian cancer: Results of a German observational study. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.16552] [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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Chekerov R, Denkert C, Boehmer D, Suesse A, Widing A, Ruhmland B, Giese A, Mustea A, Lichtenegger W, Sehouli J. Online tumor conference in the clinical management of gynecological cancer: experience from a pilot study in Germany. Int J Gynecol Cancer 2008; 18:1-7. [PMID: 17466034 DOI: 10.1111/j.1525-1438.2007.00971.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.6] [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: 11/29/2022] Open
Abstract
The concept of the online tumor conference was established in 2004 as a pilot project. We developed specific web-based software to organize and conduct online tumor board meetings of gynecologists, surgeons, radiologists, oncologists, and pathologists from different hospitals and gynecological practitioners, discussing individual patient's cases, defining therapy options, and exchanging clinical experience. Following a didactic approach, patient data are presented to the participants, with a special focus toward patient's preference and late toxicity from prior therapy. Then different national (eg, Arbeitsgemeinschaft Gynaekologische Onkologie, Deutsche Gesellschag fur Gynaekologic und Geburtshilfe) and international guidelines (eg, American Society of Clinical Oncology, National Cancer Institute), current study results based on literature review and open clinical trials are discussed. An individual diagnosis and therapy recommendation for each patient is reached by consensus. All protocols, guidelines, and publication data are upgraded and dispersed via Internet for all participants. In the period from December 2004 to August 2006, 39 tumor board conferences were performed with a total of 667 participants. One hundred forty-four patients' cases were presented, and 121 peer-reviewed second-opinions were sought. In an anonymous survey, 84% of the participants reported to be satisfied with the information content and 72% with the technical support. Overall 98% of the individual therapy recommendations were accepted and implemented. The tumor board conference presents an optimal possibility for extensive scientific discussions and exchange (92%) and improves advanced educational training (81%). In conclusion, the online tumor conference is feasible and represents a time-saving possibility for gynecological oncologist to receive a treatment recommendation based on the best available clinical and scientific evidence.
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Affiliation(s)
- R Chekerov
- Department of Obstetrics and Gynecology, Campus Virchow, Charité University Hospital, Berlin, Germany
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Chekerov R, Sehouli J, Mustea A, Süße A, Klare P, Ruhmland B, Lichtenegger W. Interdisciplinary Online Tumorconference: Implementation of a new tool in the management of gynaecological cancers in Germany. Geburtshilfe Frauenheilkd 2006. [DOI: 10.1055/s-2006-952530] [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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Braicu EI, Mustea A, Koensgen D, Pirvulescu C, Sun P, Chekerov R, Nuernberg P, Toliat MR, Lichtenegger W, Sehouli J. Effects of polymorphism (plm) in interleukin (IL) 1 and IL10 genes on surgery outcome in ovarian cancer (OC). J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.20094] [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
20094 Background: IL1 and IL10 are overexpressed in 55% to 98% of advanced epithelial OC. Different studies demonstrated IL1 and IL10 as independent prognostic factors for OC. This study was performed to investigate the influence of plms of IL-1A, IL-1B and IL-10 gene on the occurrence tumor biology of OC. Methods: In a prospective, monocentric, case-control study 147 pts with OC (71 pts with primary OC and 77 pts with recurrent OC) and 129 pts with no history of malignancies were genotyped for plms of the IL-1 gene (IL-1A -889 T/C and IL-1B -511 C/T promoter) and IL-10 gene (IL-10 -1082 G/A, -819 C/T and -592 C/A). All pts were collected within Tumor bank Ovarian Cancer Project. Genomic DNA fragments were amplified by PCR and the allele sequences were obtained by pyrosequencing. We analyzed significance using the Chi-Square by Pearson and Fisher’s exact test. Statistical significance was determined by Mann-Whitney test. A two-tailed p value <0.05 was considered statistically significant. Overall survival (OS) was estimated using the Kaplan-Meier product limited method. Results: The median age of the pts with OC was 55.5 years (range 19–81 y). Median follow-up period was: 31.5 months (range: 1–225 mo). There were no significant associations between allelic frequencies for IL-1A and IL-1B in OC. The IL-10 plm in -819 and -592 positions significantly correlates with the postoperative residual tumor (p = 0.036 and p = 0.035 respectively). For pts without any postoperative tumor residuals the most encountered genotype was C/C at −819 and −592. The same genotype was associated in univariate analysis with a better OS (95% CI = 37.5–94.5 and 40.8–91.2, respectively). In the multivariate models there was no correlation between any plms and disease-free and OS. Postoperative residual tumor (OR =0.202, 95% CI = 0.088–0.462, p = 0.0001) and ascites volume (OR = 0.106, 95% CI = 0.046–0.248, p = 0.026) were independent prognostic factors for reduced OS. Conclusions: Plm of IL1A, IL1B, IL10 showed no association with occurrence of OC. IL-10 promoter plm may influence the tumor biology and could potentially predict results of radical surgery. No significant financial relationships to disclose.
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Affiliation(s)
- E. I. Braicu
- Charité Medical University, Berlin, Germany; University of Cologne, Cologne, Germany
| | - A. Mustea
- Charité Medical University, Berlin, Germany; University of Cologne, Cologne, Germany
| | - D. Koensgen
- Charité Medical University, Berlin, Germany; University of Cologne, Cologne, Germany
| | - C. Pirvulescu
- Charité Medical University, Berlin, Germany; University of Cologne, Cologne, Germany
| | - P. Sun
- Charité Medical University, Berlin, Germany; University of Cologne, Cologne, Germany
| | - R. Chekerov
- Charité Medical University, Berlin, Germany; University of Cologne, Cologne, Germany
| | - P. Nuernberg
- Charité Medical University, Berlin, Germany; University of Cologne, Cologne, Germany
| | - M. R. Toliat
- Charité Medical University, Berlin, Germany; University of Cologne, Cologne, Germany
| | - W. Lichtenegger
- Charité Medical University, Berlin, Germany; University of Cologne, Cologne, Germany
| | - J. Sehouli
- Charité Medical University, Berlin, Germany; University of Cologne, Cologne, Germany
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