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Illert AL, Stenzinger A, Bitzer M, Horak P, Gaidzik VI, Möller Y, Beha J, Öner Ö, Schmitt F, Laßmann S, Ossowski S, Schaaf CP, Hallek M, Brümmendorf TH, Albers P, Fehm T, Brossart P, Glimm H, Schadendorf D, Bleckmann A, Brandts CH, Esposito I, Mack E, Peters C, Bokemeyer C, Fröhling S, Kindler T, Algül H, Heinemann V, Döhner H, Bargou R, Ellenrieder V, Hillemanns P, Lordick F, Hochhaus A, Beckmann MW, Pukrop T, Trepel M, Sundmacher L, Wesselmann S, Nettekoven G, Kohlhuber F, Heinze O, Budczies J, Werner M, Nikolaou K, Beer AJ, Tabatabai G, Weichert W, Keilholz U, Boerries M, Kohlbacher O, Duyster J, Thimme R, Seufferlein T, Schirmacher P, Malek NP. The German Network for Personalized Medicine to enhance patient care and translational research. Nat Med 2023:10.1038/s41591-023-02354-z. [PMID: 37280276 DOI: 10.1038/s41591-023-02354-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
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Lecuru F, Sehouli J, Vergote I, Reuss A, Classe JM, Hillemanns P, Greggi S, Mirza M, Brachet P, Follana P, Raban N, Hasenburg A, Zang R, Lindemann K, Kim JW, Poveda A, Raspagliesi F, Haslund C, du Bois A, Harter P. 573P Role of CA125 in patients included in the DESKTOP III/ENGOT-ov20 trial. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Kampers J, Gerhardt E, Sibbertsen P, Flock T, Klapdor R, Hertel H, Jentschke M, Hillemanns P. Protective operative techniques in radical hysterectomy in early cervical carcinoma and their influence on disease-free and overall survival: a systematic review and meta-analysis of risk groups. Arch Gynecol Obstet 2021; 304:577-587. [PMID: 34021804 PMCID: PMC8325671 DOI: 10.1007/s00404-021-06082-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 04/27/2021] [Indexed: 12/12/2022]
Abstract
Purpose Radical hysterectomy with pelvic lymphadenectomy presents the standard treatment for early cervical cancer. Recently, studies have shown a superior oncological outcome for open versus minimal invasive surgery, however, the reasons remain to be speculated. This meta-analysis evaluates the outcomes of robotic and laparoscopic hysterectomy compared to open hysterectomy. Risk groups including the use of uterine manipulators or colpotomy were created. Methods Ovid-Medline and Embase databases were systematically searched in June 2020. No limitation in date of publication or country was made. Subgroup analyses were performed regarding the surgical approach and the endpoints OS and DFS. Results 30 studies fulfilled the inclusion criteria. Five prospective, randomized-control trials were included. Patients were analyzed concerning the surgical approach [open surgery (AH), laparoscopic surgery (LH), robotic surgery (RH)]. Additionally, three subgroups were created from the LH group: the LH high-risk group (manipulator), intermediate-risk group (no manipulator, intracorporal colpotomy) and LH low-risk group (no manipulator, vaginal colpotomy). Regarding OS, the meta-analysis showed inferiority of LH in total over AH (0.97 [0.96; 0.98]). The OS was significantly higher in LH low risk (0.96 [0.94; 0.98) compared to LH intermediate risk (0.93 [0.91; 0.94]). OS rates were comparable in AH and LH Low-risk group. DFS was higher in the AH group compared to the LH group in general (0.92 [95%-CI 0.88; 0.95] vs. 0.87 [0.82; 0.91]), whereas the application of protective measures (no uterine manipulator in combination with vaginal colpotomy) was associated with increased DFS in laparoscopy (0.91 [0.91; 0.95]). Conclusion DFS and OS in laparoscopy appear to be depending on surgical technique. Protective operating techniques in laparoscopy result in improved minimal invasive survival. Supplementary Information The online version contains supplementary material available at 10.1007/s00404-021-06082-y.
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Röttger M, Hermann H, Hillemanns P, Kaukemüller L, Klapdor R. Sentinellymphonodektomie beim Vulvakarzinom – Eine Umfrage zu Wissensstand, Stellenwert und Beratung im ambulanten Bereich. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1718177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Kohls F, Hillemanns P, von Kaisenberg C, Brodowski L. Ökonomische Bewertung der Adipositas in der Geburtshilfe am Beispiel der primären Sectio caesarea. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1717905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Kampers J, Börmer G, Ertik F, Hillemanns P, Jentschke M. CoCoss-trial: Concurrent comparison of self-sampling devices for HPV-detection. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1718149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Woelber L, Bommert M, Harter P, Prieske K, zu Eulenburg C, Jueckstock J, Hilpert F, de Gregorio N, Iborra S, Sehouli J, Ignatov A, Hillemanns P, Fuerst S, Strauss HG, Baumann K, Thiel F, Mustea A, Meier W, Wimberger P, Hanker L, Schmalfeldt B, Canzler U, Fehm T, Luyten A, Hellriegel M, Kosse J, Heiss C, Hantschmann P, Mallmann P, Tanner B, Pfisterer J, Mahner S, Jaeger A. Role of pelvic lymph node resection in vulvar cancer – a subset analysis of the AGO-CaRE-1 study. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1717203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Prieske K, Woelber L, Muallem M, Eulenburg C, Jückstock J, Hilpert F, de Gregorio N, Iborra S, Ignatov A, Hillemanns P, Fuerst S, Strauss H, Baumann K, Thiel F, Mustea A, Meier W, Harter P, Wimberger P, Hanker L, Schmalfeldt B, Canzler U, Fehm T, Luyten A, Hellriegel M, Kosse J, Heiss C, Hantschmann P, Mallmann P, Tanner B, Pfisterer J, Sehouli J, Mahner S. The influence of age on treatment and prognosis of patients with squamous cell vulvar cancer (VSCC)- a subset analysis of the AGO-CaRE-1 study. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1718171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Klapdor R, Röttger M, Hillemanns P, Jentschke M, Hertel H. Laparoskopische radikale Hysterektomie beim Zervixkarzinom: Ist die peritoneale Tumorzellverschleppung ein unterschätztes Ereignis? Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1718150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Klapdor R, Kruppa M, Kleine M, Imkamp F, Schmidt J, Hertel H, Hillemanns P. Das SOCIUS-Mentoring Programm – Next-Level Förderung des gynäkologisch-onkologischen Nachwuchses. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1717168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Harter P, Sehouli J, Meier W, Reuss A, Hillemanns P, Hasenburg A, Hilpert F, Denschlag D, Burges A, Hanker L, Lampe B, Canzler U, Gropp-Meier M, du Bois A. Randomized phase III study to evaluate the impact of secondary cytoreductive surgery in recurrent ovarian cancer – final analysis of AGO DESKTOP III/ENGOT- ov20. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1717176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Jentschke M, Kampers J, Becker J, Sibbertsen P, Hillemanns P. Prophylactic HPV vaccination after conization: A systematic review and meta-analysis. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1717205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Brodowski L, Hillemanns P, Hertel H, Kohls F. Ökonomische Bewertung der operativen Therapie des Zervixkarzinoms. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1718154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Philippeit A, Schmidt JC, von Kaisenberg C, Hillemanns P, Lewinski H, Haunschild T, Klapdor R. MEWU – Ein internationales Hebammenaustauschprogramm zwischen Deutschland und Uganda zur Optimierung der geburtshilflichen Versorgung. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1717959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Kaukemüller L, Klapdor R, Röttger M, Jentschke M, Hillemanns P, Hertel H. Etablierung des DaVinci Operations-Robotersystems in der operativen Gynäkologie. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1718028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Vu TH, Kaukemüller L, Klapdor R, Hillemanns P, Hertel H. Robotisches lateral repair/Kolposuspension: Eine Alternative zu netzgestützter Descensus- und Inkontinenzchirurgie – Verfahren & Ergebnisse. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1717202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Schnelzer A, Harter P, Sehouli J, Canzler U, Marmé F, De Gregorio N, Buderath P, Lück HJ, Gropp-Meier M, Runnebaum I, Belau A, Renner S, Schmalfeldt B, El-Balat A, Burges A, Hillemanns P, Denschlag D, Bauerschlag D, Hanker L, Ray-Coquard I. Phase III PAOLA-1/ENGOT-ov25 trial: Olaparib plus bevacizumab (bev) as maintenance therapy in patients (pts) with newly diagnosed, advanced ovarian cancer (OC) treated with platinum-based chemotherapy (PCh) plus bev. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1717197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Kaukemüller L, Klapdor R, Vu T, Jentschke M, Hillemanns P, Hertel H. Robotische Chirurgie in der Urogynäkologie: Indikationen und Spektren. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1718027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Jentschke M, Kampers J, Becker J, Sibbertsen P, Hillemanns P. Prophylactic HPV vaccination after conization: A systematic review and meta-analysis. Vaccine 2020; 38:6402-6409. [PMID: 32762871 DOI: 10.1016/j.vaccine.2020.07.055] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 07/24/2020] [Accepted: 07/25/2020] [Indexed: 02/08/2023]
Abstract
INTRODUCTION Human papillomavirus (HPV) vaccination is essential for cervical cancer prevention. However, the value of HPV vaccination in the context excisional treatment of high-grade cervical intraepithelial neoplasia (CIN 3) remains unclear. METHODS In this meta-analysis, three retrospective and three prospective studies, three post-hoc analyses of RCTs and one cancer registry study analysing the effect of pre- or post-conization vaccination (bi- or quadrivalent vaccine) against HPV were included after a systematic review of literature. Random-effect models were prepared to evaluate the influence of vaccination on recurrent CIN 2+. RESULTS Primary end point was CIN2+ in every study. The overall study population included 21,059 patients (3,939 vaccinations vs. 17,150 controls). The results showed a significant risk reduction for the development of new high-grade intraepithelial lesions after HPV vaccination (relative risk (RR) 0.41; 95% CI [0.27; 0.64]), independent from HPV type. Due to the heterogeneous study population multiple sub analyses regarding HPV type, age of patients, time of vaccination and follow-up were performed. Age-dependent analysis showed no differences between women under 25 years (RR 0.47 (95%-CI [0.28; 0.80]) and women of higher age (RR 0.52 (95%-CI [0.41; 0.65]). Results for HPV 16/18 positive CIN2+ showed a RR of 0.37 (95% CI [0.17; 0.80]). Overall, the number of women that would have to be vaccinated before or after conization to prevent one case of recurrent CIN 2+ (NNV) is 45.5. CONCLUSION Meta-analysis showed a significant risk reduction of developing recurrent cervical intraepithelial neoplasia after surgical excision and HPV vaccination compared to surgical excision only.
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Jueckstock J, Fuerst S, Bommert M, Harter P, Prieske K, Eulenburg C, Hilpert F, deGregorio N, Iborra S, Sehouli J, Ignatov A, Hillemanns P, Jaeger A, Strauss HG, Baumann K, Thiel F, Mustea A, Meier W, Wimberger P, Hanker L, Schmalfeldt B, Canzler U, Fehm T, Luyten A, Hellriegel M, Kosse J, Heiss C, Hantschmann P, Mallmann P, Tanner B, Pfisterer J, Woelber L, Mahner S. Bedeutung der pelvinen Lymphonodektomie beim Plattenepithelkarzinom der Vulva (VSCC) – Subgruppenanalyse der AGO-CaRE-1 Studie. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1713981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Jentschke M, Lehmann R, Drews N, Hansel A, Schmitz M, Hillemanns P. Psychological distress in cervical cancer screening: results from a German online survey. Arch Gynecol Obstet 2020; 302:699-705. [PMID: 32594298 PMCID: PMC7447652 DOI: 10.1007/s00404-020-05661-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Accepted: 06/18/2020] [Indexed: 12/24/2022]
Abstract
Purpose The PODCAD study aimed at assessing the degree of psychological stress that women experience due to notification of an abnormal Papanicolaou (Pap) smear finding or a positive human papillomavirus (HPV) test result. Methods We designed a survey to address the question of psychological burden due to abnormal Pap smear results and/or positive HPV tests. In this online campaign approach, we aimed to reach > 2000 women all over Germany irrespective of kind and number of abnormal screening findings. We asked for different kinds of anxiety, distress and uncertainty regarding both, Pap and HPV status. Results A total of 3753 women completed the survey at least partially, and almost 2300 fully completed the survey. Of these, more than 50% were affected already since more than 1 year, and almost half of them had experienced at least three Pap smears in follow-up examinations. Almost 70% of the women were afraid of developing cancer. Intriguingly, almost half of the women with abnormal findings were not aware of their stage of the Pap smear. Furthermore, almost 30% of the women displayed signs of a post-traumatic stress disorder. Conclusion Abnormal results in cervical cancer screening have an impact on patients’ psychology, irrespective of the knowledge and severity of the findings. Better information concerning risks and benefits of cervical cancer screening and about the meaning of the outcome of its procedures are required to decrease this anxiety. Electronic supplementary material The online version of this article (10.1007/s00404-020-05661-9) contains supplementary material, which is available to authorized users.
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Kuehnle E, Kaur P, Siggelkow W, Luebbe K, Schrader I, Uleer C, Noeding S, Noeding KH, Noesselt T, Arfsten M, Busch C, Krentel N, Hillemanns P, Dörk T, Park-Simon TW. Abstract P1-15-10: A prospective multicenter real-world study on neoadjuvant treatment and clinical outcome in TNBC patients. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p1-15-10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Introduction
Controversy exists with regards to the optimal regimen for neoadjuvant chemotherapy (NAC) of TNBC. Platinum-based regimens seem to be more active in TNBC improving pCR rates significantly. But adding platinum to an anthracycline/taxane chemotherapy regime comes at the expense of greater toxicity. Its impact on survival and long-term-outcomes remains undetermined. Practical guidelines vary across leading international professional societies. In this real-world multicenter study neoadjuvant regimens, pCR rates and survival were evaluated.
Material and methods
This study was conducted from 2012-2017 in six certified breast cancer centers in the region of Hanover, Germany, including rural and urban populations by using a personal questionnaire and data from the medical records. All patients with primary TNBC (ER<1%, PR<1%, Her2/neu 0, 1+ or 2+ FISH/CISH negative) and no evidence of distant disease were eligible.
Results
143/217 patients (66%) received NAC and 74/217patients (34%) adjuvant chemotherapy. 63/143 (44%) patients achieved pCR. 23/63 (35%) received platinum-based NAC and 40/63 (65%) received chemotherapy without platinum. In 80 patients pCR was not achieved. 12/80 patients received platinum and 68/80 non platinum-based NAC. pCR was significantly higher among patients with platinum-based chemotherapy (chi-square, p < 0.003). 20/23 patients who achieved pCR received NAC containing anthracycline/taxane/carboplatin, 3/23 patients received a taxane/carboplatin-based regime. Treatment discontinuation was seen in 12/35 (34%) patients receiving platinum-based NAC vs 15/108 (14%) in non-platinum-based NAC. Mean follow up was 17 months (1-70months). A significant difference in OS (p=0.007) and DFS (p=0.001) was seen for patients with a pCR.
Conclusion
Our trial confirms that platinum based NAC achieves significantly higher rates of pCR in patients with TNBC. pCR was associated with significantly longer DFS and OS. The CALBG protocol (CALBG 40603) was the preferred choice of treatment regimen followed by the GeparSixto protocol. In our study the pCR rate was comparable to that of both trials in which pCR rates of 60% (CALBG 40603) and 53% (GeparSixto) were achieved. However, in our trial 34% of the patients discontinued treatment due to toxicity. Therefore these protocols should be used in carefully selected patients. In a real world setting less toxic chemotherapy regimens achieved a pCR rate of 37%. In terms of toxicity and adherence to chemotherapy, these regimens are reasonable alternative options. In daily care close monitoring of treatment response is essential during NAC. In patients who have a rapid clinical response to platinum-free NAC the benefit of adding platinum is questionable. In contrast, the addition of platinum seems to be appropriate in those patients who show only limited response under NAC.
Citation Format: Kuehnle E, Kaur P, Siggelkow W, Luebbe K, Schrader I, Uleer C, Noeding S, Noeding K-H, Noesselt T, Arfsten M, Busch C, Krentel N, Hillemanns P, Dörk T, Park-Simon T-W. A prospective multicenter real-world study on neoadjuvant treatment and clinical outcome in TNBC patients [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P1-15-10.
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Fischer F, Beckmeier S, Klapdor R, Hillemanns P, Hertel H. Behandlung des Beckenbodendescensus im mittleren Kompartiment – wie gut sind uteruserhaltende Operationsmethoden? Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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Kühnle E, Jungk J, Klapdor R, Kohls F, Hillemanns P, Staboulidou I. Einfluss von 3D Ultraschall und Beschäftigungstherapie auf die Entwicklung depressiver Symptome von hospitalisierten Risikoschwangeren. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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Jentschke M, Bau E, Hass R, Hertel H, Kampers J, Klapdor R, Soergel P, Hillemanns P. Humane Papillomvirus Messenger RNA aus Lymphknoten zur Sentineldiagnostik bei Patientinnen mit Zervixkarzinom. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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