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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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Armbrust R, Neeb C, Thuss-Patience P, Lüftner D, Pietzner K, Riess H, Oskay-Öczelik G, Richter R, Keller M, Sehouli J. Patients' perspectives towards malignant ascites: results of a prospective observational trial regarding expectations, characteristics and quality of life-a study of the North-Eastern-German Society of Gynecological Oncology. Arch Gynecol Obstet 2019; 299:1385-1389. [PMID: 30834969 DOI: 10.1007/s00404-019-05071-6] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Accepted: 01/28/2019] [Indexed: 11/29/2022]
Abstract
PURPOSE Malignant ascites (MA) is a frequent and common symptom in (gyneco-) oncological patients. The present trial evaluated and assessed patients' characteristics, clinical features and the possible influence of MA on QoL measurements. METHODS A prospective observational trial was conducted from Oct 2013 until Nov 2016. Therefore an interdisciplinary questionnaire was developed. Overall 250 patients with histological confirmed MA were included with different cancer entities (gynecological, gastrointestinal). The correlation of MA caused symptoms and QoL measurements was assessed using Kendall's tau b. Multivariable logistic regression models were applied to analyze the risks of symptoms or severe limitation in daily activities. RESULTS 125 questionnaires could be analyzed. The majority of patients with MA had diagnosis of ovarian cancer (68.8%) and were under current cancer treatment (57.6%), mostly chemotherapy. Over 50% reported abdominal tension as major symptom, around 56% of the patients had MA when cancer was firstly diagnosed. Regression analysis showed that patients with MA above 2l were significantly more likely to be harmed in everyday activities. However, the age, gender, type of malignancy and the current treatment (chemotherapy vs. no chemotherapy) had no significant influence. CONCLUSION MA has a significantly impact on QoL measurements in cancer patients and might influence everyday activities including basic needs like eating, walking and body care. There is a high need for more information and education of patients with MA.
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Affiliation(s)
- Robert Armbrust
- Department of Gynecology With Center for Oncological Surgery, Charité European Competence Center for Ovarian Cancer, University Hospital Charité Berlin, Augustenburger Platz 1, 13353, Berlin, Germany. .,North-Eastern German Society of Gynecological Oncology (NOGGO), Augustenburger Platz 1, 13353, Berlin, Germany.
| | - C Neeb
- Department of Gynecology With Center for Oncological Surgery, Charité European Competence Center for Ovarian Cancer, University Hospital Charité Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - P Thuss-Patience
- Department of Hematology, Oncology and Tumor Immunology, University Hospital Charité Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - D Lüftner
- Department of Hematology, Oncology and Tumor Immunology, University Hospital Charité Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - K Pietzner
- Department of Gynecology With Center for Oncological Surgery, Charité European Competence Center for Ovarian Cancer, University Hospital Charité Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.,North-Eastern German Society of Gynecological Oncology (NOGGO), Augustenburger Platz 1, 13353, Berlin, Germany
| | - H Riess
- Department of Hematology, Oncology and Tumor Immunology, University Hospital Charité Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - G Oskay-Öczelik
- Department of Gynecology With Center for Oncological Surgery, Charité European Competence Center for Ovarian Cancer, University Hospital Charité Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.,North-Eastern German Society of Gynecological Oncology (NOGGO), Augustenburger Platz 1, 13353, Berlin, Germany
| | - R Richter
- Department of Gynecology With Center for Oncological Surgery, Charité European Competence Center for Ovarian Cancer, University Hospital Charité Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - M Keller
- North-Eastern German Society of Gynecological Oncology (NOGGO), Augustenburger Platz 1, 13353, Berlin, Germany
| | - J Sehouli
- Department of Gynecology With Center for Oncological Surgery, Charité European Competence Center for Ovarian Cancer, University Hospital Charité Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.,North-Eastern German Society of Gynecological Oncology (NOGGO), Augustenburger Platz 1, 13353, Berlin, Germany
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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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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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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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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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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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Buttmann-Schweiger N, Barnes B, Woopen H, Braicu I, Pietzner K, Sehouli J. Retrospective study of long-term epithelial ovarian cancer survivors: clinical data and population-based cancer registry data. Das Gesundheitswesen 2017. [DOI: 10.1055/s-0037-1606027] [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: 10/18/2022]
Affiliation(s)
| | - B Barnes
- Robert Koch-Institut, Zentrum für Krebsregisterdatem (ZfKD), Berlin
| | - H Woopen
- Universitätsmedizin Berlin Charité, Klinik für Gynäkologie mit Zentrum für onkologische Chirurgie, Berlin
| | - I Braicu
- Universitätsmedizin Berlin Charité, Klinik für Gynäkologie mit Zentrum für onkologische Chirurgie, Berlin
| | - K Pietzner
- Universitätsmedizin Berlin Charité, Klinik für Gynäkologie mit Zentrum für onkologische Chirurgie, Berlin
| | - J Sehouli
- Universitätsmedizin Berlin Charité, Klinik für Gynäkologie mit Zentrum für onkologische Chirurgie, Berlin
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Taube ET, Denkert C, Pietzner K, Dietel M, Sehouli J, Darb-Esfahani S. Prognostic impact of neuroendocrine differentiation in high-grade serous ovarian carcinoma. Virchows Arch 2014; 466:333-42. [PMID: 25522951 DOI: 10.1007/s00428-014-1710-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2014] [Revised: 11/29/2014] [Accepted: 12/08/2014] [Indexed: 01/07/2023]
Abstract
Neuroendocrine differentiation in high-grade serous ovarian carcinomas has only rarely been described. However, in our consultancy experience, we have been pointed at a case of neuroendocrine relapse in a patient with high-grade serous ovarian carcinoma where retrospectively, a minor neuroendocrine component in the primary tumor could be detected. Hypothesizing that immunohistochemical evidence of neuroendocrine differentiation might be more frequent in ovarian carcinoma than suspected by morphology, we immunophenotyped the tissue microarrays (TMAs) of a cohort of 178 high-grade serous carcinomas for chromogranin and synaptophysin expression. Synaptophysin expression was found in 12 (6.7 %) out of 172 patients, and chromogranin A expression was seen in 36 (20.7 %) out of 174 patients. Kaplan-Meier analysis revealed that carcinomas with synaptophysin expression of >20 % of positive cells (n = 4) had a significantly shorter survival time than those with 0-20 % of positive cells (p < 0.0001). Synaptophysin expression remained a significant prognostic factor in multivariate analysis (HR = 10.82, 95 % confidence interval 3.10-37.71, p < 0.0001), independently of age, FIGO stage, and residual tumor after surgery. A trend toward shorter survival was seen in patients with tumors that expressed chromogranin, irrespective of the amount of positive cells (p = 0.173). A neuroendocrine differentiation is important to keep in mind when a neuroendocrine tumor of unknown primary is detected in regional or temporal connection with an ovarian carcinoma. A minor neuroendocrine component in ovarian high-grade serous carcinomas might imply a dismal prognosis.
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MESH Headings
- Adult
- Aged
- Biomarkers, Tumor/metabolism
- Cell Differentiation
- Chromogranins/metabolism
- Female
- Gene Expression Regulation, Neoplastic
- Humans
- Immunophenotyping
- Kaplan-Meier Estimate
- Middle Aged
- Neoplasms, Cystic, Mucinous, and Serous/diagnosis
- Neoplasms, Cystic, Mucinous, and Serous/metabolism
- Neoplasms, Cystic, Mucinous, and Serous/pathology
- Neurosecretory Systems/pathology
- Ovarian Neoplasms/diagnosis
- Ovarian Neoplasms/metabolism
- Ovarian Neoplasms/pathology
- Prognosis
- Retrospective Studies
- Synaptophysin/metabolism
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Affiliation(s)
- E T Taube
- Institute of Pathology, Charité University Hospital, Charitéplatz 1, 10117, Berlin, Germany,
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Fotopoulou C, Savvatis K, Kosian P, Braicu IE, Papanikolaou G, Pietzner K, Schmidt SC, Sehouli J. Quaternary cytoreductive surgery in ovarian cancer: does surgical effort still matter? Br J Cancer 2013; 108:32-8. [PMID: 23321509 PMCID: PMC3553531 DOI: 10.1038/bjc.2012.544] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Background: To evaluate surgical outcome and survival benefit after quaternary cytoreduction (QC) in epithelial ovarian cancer (EOC) relapse. Methods: We systematically evaluated all consecutive patients undergoing QC in our institution over a 12-year period (October 2000–January 2012). All relevant surgical and clinical outcome parameters were systematically assessed. Results: Forty-nine EOC patients (median age: 57; range: 28–76) underwent QC; in a median of 16 months (range:2–142) after previous chemotherapy. The majority of the patients had an initial FIGO stage III (67.3%), peritoneal carcinomatosis (77.6%) and no ascites (67.3%). At QC, patients presented following tumour pattern: lower abdomen 85.7% middle abdomen 79.6% and upper abdomen 42.9%. Median duration of surgery was 292 min (range: a total macroscopic tumour clearance could be achieved. Rates of major operative morbidity and 30-day mortality were 28.6% and 2%, respectively. Mean follow-up from QC was 18.41 months (95% confidence interval (CI):12.64–24.18) and mean overall survival (OS) 23.05 months (95% CI: 15.5–30.6). Mean OS for patients without vs any tumour residuals was 43 months (95% CI: 26.4–59.5) vs 13.4 months (95% CI: 7.42–19.4); P=0.001. Mean OS for patients who received postoperative chemotherapy (n=18; 36.7%) vs those who did not was 40.5 months (95% CI: 27.4–53.6) vs 12.03 months (95% CI: 5.9–18.18); P<0.001. Multivariate analysis indentified multifocal tumour dissemination to be of predictive significance for incomplete tumour resection, higher operative morbidity and lower survival, while systemic chemotherapy subsequent to QC had a protective significant impact on OS. No prognostic impact had ascites, platinum resistance, high grading and advanced age. Conclusion: Even in this highly advanced setting of the third EOC relapse, maximal therapeutic effort combining optimal surgery and chemotherapy appear to significantly prolong survival in a selected patients ‘group’.
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Affiliation(s)
- C Fotopoulou
- Department of Gynecology, Charité University Medical Center Berlin, 13353 Berlin, Germany.
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Woopen H, Sehouli J, Pietzner K, Darb-Esfahani S, Braicu E, Fotopoulou C. Clinical experience of young patients with small cell ovarian carcinoma of the hypercalcemic type (OSCCHT). Eur J Obstet Gynecol Reprod Biol 2012; 165:313-7. [DOI: 10.1016/j.ejogrb.2012.07.034] [Citation(s) in RCA: 14] [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: 03/22/2012] [Revised: 06/28/2012] [Accepted: 07/29/2012] [Indexed: 11/24/2022]
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Woopen H, Pietzner K, Darb-Esfahani S, Oskay-Oezcelik G, Sehouli J. Extraperitoneal response to intraperitoneal immunotherapy with catumaxomab in a patient with cutaneous lymphangiosis carcinomatosa from ovarian cancer: a case report and review of the literature. Med Oncol 2012; 29:3416-20. [DOI: 10.1007/s12032-012-0285-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2012] [Accepted: 06/14/2012] [Indexed: 11/29/2022]
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David M, Radke AM, Pietzner K. The Prescription of the Morning-After Pill in a Berlin Emergency Department Over a Four-Year Period - User Profiles and Reasons for Use. Geburtshilfe Frauenheilkd 2012; 72:392-396. [PMID: 25298542 DOI: 10.1055/s-0031-1298446] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [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: 02/24/2012] [Revised: 03/19/2012] [Accepted: 03/20/2012] [Indexed: 10/28/2022] Open
Abstract
Questions: There are no current health care studies from Germany regarding the "morning-after pill". This paper will use routine data to analyse details regarding the users' profiles, reasons for using it and the utilisation of hospital outpatient facilities. Patient Collective and Methods: Retrospective analysis of all triage sheets in the emergency department of the Virchow Hospital Campus/Charité University Hospital, Berlin, over a four-year period from 2007 to 2010 that were coded with the ICD diagnosis Z30 (= contraception advice) and statistical processing of the associated administrative data. Results: 860 triage sheets were included in the analysis. The emergency department is used most frequently for the prescription of the "morning-after pill" at the weekend. The average age of the users was 25.1 years. The most common reason cited for needing emergency contraception was unprotected sexual intercourse, with the second-most common being "condom failure". Around half of the women attended the department within 12 hours of having unprotected sex. Less than 2 % (n = 14) of all women decided against a prescription of emergency contraceptive after counselling. Conclusions: The user profile and reasons for using emergency oral contraception correlate largely with the information contained in international literature. Although the "morning-after pill" is probably prescribed mainly in general practices in Germany, and despite the availability of new drugs with a permitted post-exposure interval of up to 120 hours after unprotected sex, there appears to still be a high demand for counselling and prescriptions of the "morning-after pill" in the context of the emergency department.
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Affiliation(s)
- M David
- Department of Gynaecology, Charité - University Medicine Berlin, Virchow Hospital Campus, Berlin
| | - A-M Radke
- Department of Gynaecology, Charité - University Medicine Berlin, Virchow Hospital Campus, Berlin
| | - K Pietzner
- Department of Obstetric Medicine, Charité - University Medicine Berlin, Virchow Hospital Campus, Berlin
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Sehouli J, Papanikolaou G, Braicu EI, Pietzner K, Neuhaus P, Fotopoulou C. Feasibility of Surgery After Systemic Treatment with the Humanized Recombinant Antibody Bevacizumab in Heavily Pretreated Patients with Advanced Epithelial Ovarian Cancer. Ann Surg Oncol 2011; 19:1326-33. [DOI: 10.1245/s10434-011-2134-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2011] [Indexed: 12/29/2022]
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Braicu EI, Sehouli J, Richter R, Pietzner K, Denkert C, Fotopoulou C. Role of histological type on surgical outcome and survival following radical primary tumour debulking of epithelial ovarian, fallopian tube and peritoneal cancers. Br J Cancer 2011; 105:1818-24. [PMID: 22045193 PMCID: PMC3251879 DOI: 10.1038/bjc.2011.455] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [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] [Indexed: 12/13/2022] Open
Abstract
Background: To assess the clinical impact of the two histological types as designated in the proposed model for ovarian tumourigenesis in primary epithelial ovarian, fallopian tube or peritoneal cancer (EOC) patients. Methods: All consecutive EOC patients (n=632) after primary tumour debulking in our institution (09/2000–08/2010) were classified into one of two groups: type I tumours (n=100; 15.8%) composed of low-grade serous, low-grade endometrioid, clear cell, mucinous and transitional carcinomas; and Type II tumours (n=532; 84.1%) composed of high-grade serous, high-grade endometrioid, undifferentiated and malignant mixed-mesodermal tumours. Kaplan–Meier and logistic/Cox-regression analyses were performed to assess the impact of histological type on surgical outcome and survival. Results: Type II patients had a significantly higher incidence of advanced disease (FIGO III/IV) than Type I patients (79.8% vs 38%, respectively; P<0.001). Median CA125 values (438 vs 93 U ml−1; P=0.001); operative time (258 vs 237 min; P=0.001); and incidence of incomplete tumour resection (34.4% vs 15% P<0.001) were significantly higher in patients with Type II. During a mean follow-up time of 23 months (range: 1–106), 17% of patients with type I vs 34.8% of patients with type II tumours relapsed and/or died (P<0.001). Overall survival (P=0.021) and progression-free survival (P=0.003) were also significantly higher in patients with type I tumours. Multivariate analysis, while identifying postoperative tumour residuals, positive lymph nodes and extrapelvic dissemination as independent predictors of survival, failed to demonstrate any prognostic significance of histological type. Conclusion: Type I EOC patients appear to present at earlier stages have significantly higher survival and more optimal surgical outcome compared with type II patients. However, in advanced stages, histology loses significance as an independent prognosticator.
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Affiliation(s)
- E-I Braicu
- European Competence Center for Ovarian Cancer Department of Gynecology, Charité, Campus-Virchow-Clinic/University-Hospital, Augustenburger Platz 1, Berlin, Germany
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16
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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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18
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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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19
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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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20
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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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21
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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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22
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Schmuck RB, Pietzner K, Buckendahl A, Schönlebe J, Sehouli J. Cervical manifestation of a borderline type ovarian cancer with pseudomyxoma peritonei - a case report. Anticancer Res 2010; 30:2991-2994. [PMID: 20683044] [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: 05/29/2023]
Abstract
Borderline tumours of the ovary (BOTs) are rare tumour entities that do not show any destructive or invasive growth in the majority of cases, even though they can display characteristics of malignant tumours The mucinous subtype can also originate from the appendix, and ovarian metastases can mimic primary ovarian BOTs, often accompanied by peritoneal manifestation in terms of pseudomyxoma peritonei. In cases where a concomitant appendiceal tumour is present, it may prove difficult to determine the primary tumour. This report describes a special case of BOT with a specific example of the complexity of the differential diagnosis of pseudomyxoma peritonei. Especially the case was simultaneously linked to appendiceal and ovarian cancer. Moreover, this case was exceptional for its unusual manifestation of BOT in the cervix.
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Affiliation(s)
- R B Schmuck
- Department of Gynecology, Charité University Hospital Berlin, Berlin, Germany
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23
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Pietzner K, Linke RG, Jäger M, Lindhofer H, Friccius-Quecke H, Chen F, Braicu EI, Oskay-Özcelik G, Sehouli J. Phase II clinical trial to evaluate the safety of repeated cycles of intraperitoneal catumaxomab for the treatment of malignant ascites (SECIMAS). J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.tps155] [Citation(s) in RCA: 3] [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: 11/20/2022] Open
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24
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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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25
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Sehouli J, Pietzner K, Harter P, Münstedt K, Mahner S, Hasenburg A, Camara O, Wimberger P, Boehmer D, Buehling KJ, Richter R, El Khalfaoui K, Oskay-Ozcelik G. Prognostic role of platinum sensitivity in patients with brain metastases from ovarian cancer: results of a German multicenter study. Ann Oncol 2010; 21:2201-2205. [PMID: 20439341 DOI: 10.1093/annonc/mdq229] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Ovarian cancer is the leading cause of death in women with gynecological malignancies. Brain metastases are considered an uncommon metastatic site. Only few data exist on prognostic factors for this patient collective. PATIENTS AND METHODS A multicenter retrospective chart review was carried out including all patients with histologically confirmed ovarian cancer from six different German hospitals from 1981 to 2008. Overall, 4277 cases of patients with ovarian cancer were screened and patients with brain metastasis were identified and analyzed regarding various clinical variables and survival. RESULTS A total of 74 women with brain metastases were identified, resulting in an incidence of 1.73%. In multivariate analysis, the following clinical parameters had a significant impact on overall survival: multiple lesions [hazard ratio (HR) 4.4, 95% confidence interval (CI) 2.0-9.7] and low grading (HR 3.1, 95% CI 1.7-5.8) were associated with a negative impact. Platinum sensitivity (HR 0.23, 95% CI 0.12-0.48) was significantly associated with a favorable outcome. Good performance status (60%-80% HR 0.48, 95% CI 0.23-0.99 and 90%-100% HR 0.21, 95% CI 0.08-0.53) also had a positive impact on overall survival. CONCLUSIONS Platinum sensitivity is the most important prognostic factor in patients with ovarian cancer metastatic to the brain. This novel finding should be considered in the strategy of multimodal therapy for brain metastases in ovarian cancer.
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Affiliation(s)
- J Sehouli
- Department of Gynecology and Obstetrics, Charité-Campus Virchow Klinikum, University Medicine of Berlin, Berlin.
| | - K Pietzner
- Department of Gynecology and Obstetrics, Charité-Campus Virchow Klinikum, University Medicine of Berlin, Berlin
| | - P Harter
- Department of Gynecology & Gynecologic Oncology, Dr. Horst Schmidt Klinik (HSK), Wiesbaden
| | - K Münstedt
- Department of Obstetrics and Gynecology, Justus-Liebig-University of Giessen, Giessen
| | - S Mahner
- Department of Gynecology, University Medical Center Hamburg-Eppendorf, Hamburg
| | - A Hasenburg
- Department of Obstetrics and Gynecology, Freiburg University Medical Center, Freiburg
| | - O Camara
- Department of Gynaecology and Obstetrics, Friedrich Schiller University, Jena
| | - P Wimberger
- Department of Gynecology and Obstetrics, University Hospital Essen, Essen
| | - D Boehmer
- Department of Radiation Oncology and Radiotherapy, Charité-Campus Virchow Klinikum, University Medicine of Berlin, Berlin, Germany
| | - K J Buehling
- Department of Gynecology, University Medical Center Hamburg-Eppendorf, Hamburg
| | - R Richter
- Department of Gynecology and Obstetrics, Charité-Campus Virchow Klinikum, University Medicine of Berlin, Berlin
| | - K El Khalfaoui
- Department of Gynecology and Obstetrics, Charité-Campus Virchow Klinikum, University Medicine of Berlin, Berlin
| | - G Oskay-Ozcelik
- Department of Gynecology and Obstetrics, Charité-Campus Virchow Klinikum, University Medicine of Berlin, Berlin
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El Khalfaoui K, Oskay-Ozcelik G, Richter R, Pietzner K, Harter P, Münstedt K, Mahner S, Hasenburg A, Wimberger P, Sehouli J. Prognostic factors in ovarian cancer patients with brain metastases: Results of a German multicenter study. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.e16527] [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
e16527 Background: Ovarian cancer is one of the leading causes of mortality in women with gynaecological malignancies. Brain metastases from ovarian cancer are rare. Up to this point there are only few data about prognostic factors for this patient collective. Methods: Within a period between 1981 and 2008 we analyzed 4,277 women with histologically confirmed ovarian cancer from six different German hospitals. Overall 72 women with brain metastases and two cases of meningosis carcinomatosa were identified, these resulting in an incidence of 1.73%. Results: The median age at the diagnosis of central nervous system (CNS) metastases was 58 years (range, 33–83). The median interval between the time of the first diagnosis of ovarian cancer and the occurrence of CNS metastases was 28.8 months (range, 3.6 -133.1). The median overall survival time after diagnosis of CNS metastases was 6.1 months (range, 0.2 -41.5). Multiple brain metastases were observed in 58 women (78.4%). Headache (36.5%), vomiting and nausea (17.1%) were the most frequent clinical symptoms. According the multivariate analysis following clinical parameter reached statistical significance: multiple lesions (hazard ratio (HR): 4.1, 95% confidence intervaI (CI): 1.9 to 8.9), grading I und II (HR: 2.8, 95% CI: 1.6 to 5.0) were associated with a negative impact on overall survival. Platinum sensitivity (HR: 0.28, 95% CI: 0.15 to 0.52) and the application of multimodal therapy strategies (surgery, radiotherapy and chemotherapy) (HR: 0.51, 95% CI: 0.28 to 0.92) and the good performance (HR: 0.52; 95% CI: 0.25 to 1.08) showed a positive impact on overall survival. Tumour histology, ascites and age at the CNS diagnosis were not significant for the survival. Conclusions: Next to the presence of multiple brain lesions and the performance status, the sensitivity to platinum based chemotherapy has an important positive impact on overall survival. This should be considered in the conduction of multimodal therapy strategies for brain metastases from ovarian cancer. No significant financial relationships to disclose.
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Affiliation(s)
- K. El Khalfaoui
- Charité Medical University, Berlin, Germany; HSK, Dr. Horst Schmidt Clinic, Wiesbaden, Germany; Medecine University Hospital Gieβen, Gieβen, Germany; University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Freiburg University Hospital, Freiburg, Germany; Essen University Hospital, Essen, Germany
| | - G. Oskay-Ozcelik
- Charité Medical University, Berlin, Germany; HSK, Dr. Horst Schmidt Clinic, Wiesbaden, Germany; Medecine University Hospital Gieβen, Gieβen, Germany; University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Freiburg University Hospital, Freiburg, Germany; Essen University Hospital, Essen, Germany
| | - R. Richter
- Charité Medical University, Berlin, Germany; HSK, Dr. Horst Schmidt Clinic, Wiesbaden, Germany; Medecine University Hospital Gieβen, Gieβen, Germany; University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Freiburg University Hospital, Freiburg, Germany; Essen University Hospital, Essen, Germany
| | - K. Pietzner
- Charité Medical University, Berlin, Germany; HSK, Dr. Horst Schmidt Clinic, Wiesbaden, Germany; Medecine University Hospital Gieβen, Gieβen, Germany; University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Freiburg University Hospital, Freiburg, Germany; Essen University Hospital, Essen, Germany
| | - P. Harter
- Charité Medical University, Berlin, Germany; HSK, Dr. Horst Schmidt Clinic, Wiesbaden, Germany; Medecine University Hospital Gieβen, Gieβen, Germany; University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Freiburg University Hospital, Freiburg, Germany; Essen University Hospital, Essen, Germany
| | - K. Münstedt
- Charité Medical University, Berlin, Germany; HSK, Dr. Horst Schmidt Clinic, Wiesbaden, Germany; Medecine University Hospital Gieβen, Gieβen, Germany; University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Freiburg University Hospital, Freiburg, Germany; Essen University Hospital, Essen, Germany
| | - S. Mahner
- Charité Medical University, Berlin, Germany; HSK, Dr. Horst Schmidt Clinic, Wiesbaden, Germany; Medecine University Hospital Gieβen, Gieβen, Germany; University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Freiburg University Hospital, Freiburg, Germany; Essen University Hospital, Essen, Germany
| | - A. Hasenburg
- Charité Medical University, Berlin, Germany; HSK, Dr. Horst Schmidt Clinic, Wiesbaden, Germany; Medecine University Hospital Gieβen, Gieβen, Germany; University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Freiburg University Hospital, Freiburg, Germany; Essen University Hospital, Essen, Germany
| | - P. Wimberger
- Charité Medical University, Berlin, Germany; HSK, Dr. Horst Schmidt Clinic, Wiesbaden, Germany; Medecine University Hospital Gieβen, Gieβen, Germany; University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Freiburg University Hospital, Freiburg, Germany; Essen University Hospital, Essen, Germany
| | - J. Sehouli
- Charité Medical University, Berlin, Germany; HSK, Dr. Horst Schmidt Clinic, Wiesbaden, Germany; Medecine University Hospital Gieβen, Gieβen, Germany; University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Freiburg University Hospital, Freiburg, Germany; Essen University Hospital, Essen, Germany
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