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Maurer J, Kuenzel J, Bohr C, Koelbl O, Mueller K, Koller M, Concato OK, Vielsmeier V, Suess C. Laryngectomy plus postoperative radio(system)therapy versus primary radio(system) therapy for the treatment of locally advanced laryngeal and hypopharyngeal cancer - results from the University Clinical Cancer Registry Regensburg. Acta Otolaryngol 2024; 144:255-262. [PMID: 38664954 DOI: 10.1080/00016489.2024.2340086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Accepted: 04/01/2024] [Indexed: 06/20/2024]
Abstract
BACKGROUND There are few adequate randomized clinical trials directly comparing the therapeutic options of primary laryngectomy (pLE) vs. primary radio(system)therapy (pR(S)T) in patients with locally advanced laryngeal and hypopharyngeal carcinoma and thus little clear scientific evidence to decide which patients will benefit most from which procedure. AIMS/OBJECTIVES Aim was to compare survival between the therapeutic options and to learn from the limitations of this study, especially in the context of improved clinical assessment. MATERIAL AND METHODS The clinical data of patients treated between January 2010 and February 2022 were obtained from the electronic database of the University Hospital Regensburg. Overall survival (OS) and progression-free survival (PFS) were compared between the treatment groups. RESULTS The study included 193 patients (pLE n = 68, pR(S)T, n = 125). Median OS was 31.2 months and median PFS was 24.7 months with no significant difference between the treatment groups (p > .050). Patients who did not receive complete treatment as recommended by the tumor conference (n = 47, 24.4%) had a higher risk of death (p = .024). CONCLUSIONS AND SIGNIFICANCE The results of our study are consistent with the survival data reported in the literature. More detailed systematic data in clinical routine (e.g. relevant comorbidities) are required to ensure guideline-based recommended therapy.
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Affiliation(s)
- Julia Maurer
- University Cancer Center Regensburg, University Hospital Regensburg, Regensburg, Germany
| | - Julian Kuenzel
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Regensburg, Regensburg, Germany
| | - Christopher Bohr
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Regensburg, Regensburg, Germany
| | - Oliver Koelbl
- Department of Radiation Oncology, University Hospital Regensburg, Regensburg, Germany
| | - Karolina Mueller
- Center for Clinical Studies, University Hospital Regensburg, Regensburg, Germany
| | - Michael Koller
- Center for Clinical Studies, University Hospital Regensburg, Regensburg, Germany
| | - Oreste-Konrad Concato
- Department of Radiation Oncology, University Hospital Regensburg, Regensburg, Germany
| | - Veronika Vielsmeier
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Regensburg, Regensburg, Germany
| | - Christoph Suess
- Department of Radiation Oncology, University Hospital Regensburg, Regensburg, Germany
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Lingl JP, Böhm F, Schuler PJ, Hoffmann TK, Deininger K, Beer M, Beer AJ, Thaiss W. [Value of PET imaging in head and neck cancer]. RADIOLOGIE (HEIDELBERG, GERMANY) 2023; 63:925-936. [PMID: 37938427 DOI: 10.1007/s00117-023-01236-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2023]
Abstract
The combination of positron-emission tomography (PET) with cross-sectional imaging in particular is becoming increasingly important in the diagnosis of head and neck tumors because, in addition to pure anatomy, the metabolic activity of tissue can be visualized and assessed. The combination of PET and computed tomography (CT) is already an established procedure in head and neck tumor patients in some indications, e.g., for primary tumor detection in cancer of unknown primary (CUP) syndrome or also after completed primary radio(chemo)therapy for evaluation of response, especially also with regard to nodal status. In some cases, salvage neck dissection can thus be avoided in the case of PET-negative findings. In the context of primary diagnosis, PET/CT imaging can be used primarily to evaluate distant metastasis. According to current guidelines, PET-based imaging is not (yet) of value in determining the local extent at initial diagnosis. A challenge is the still limited reimbursement by health insurance companies, which currently allow only certain indications, and the still lack of nationwide coverage.
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Affiliation(s)
- Julia P Lingl
- Universitätsklinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Universitätsklinikum Ulm, Frauensteige 12, 89075, Ulm, Deutschland.
- i2SOUL Consortium, Surgical Oncology Ulm, Ulm, Deutschland.
| | - Felix Böhm
- Universitätsklinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Universitätsklinikum Ulm, Frauensteige 12, 89075, Ulm, Deutschland
- i2SOUL Consortium, Surgical Oncology Ulm, Ulm, Deutschland
| | - Patrick J Schuler
- Universitätsklinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Universitätsklinikum Ulm, Frauensteige 12, 89075, Ulm, Deutschland
- i2SOUL Consortium, Surgical Oncology Ulm, Ulm, Deutschland
| | - Thomas K Hoffmann
- Universitätsklinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Universitätsklinikum Ulm, Frauensteige 12, 89075, Ulm, Deutschland
- i2SOUL Consortium, Surgical Oncology Ulm, Ulm, Deutschland
| | - Katharina Deininger
- Klinik für Nuklearmedizin, Universitätsklinikum Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Deutschland
- i2SOUL Consortium, Surgical Oncology Ulm, Ulm, Deutschland
| | - Meinrad Beer
- Diagnostische und Interventionelle Radiologie, Universitätsklinikum Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Deutschland
- i2SOUL Consortium, Surgical Oncology Ulm, Ulm, Deutschland
| | - Ambros J Beer
- Klinik für Nuklearmedizin, Universitätsklinikum Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Deutschland
- i2SOUL Consortium, Surgical Oncology Ulm, Ulm, Deutschland
| | - Wolfgang Thaiss
- Klinik für Nuklearmedizin, Universitätsklinikum Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Deutschland
- Diagnostische und Interventionelle Radiologie, Universitätsklinikum Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Deutschland
- i2SOUL Consortium, Surgical Oncology Ulm, Ulm, Deutschland
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Lingl JP, Böhm F, Schuler PJ, Hoffmann TK, Deininger K, Beer M, Beer AJ, Thaiss W. [Value of PET imaging in head and neck cancer]. HNO 2023; 71:681-692. [PMID: 37702793 DOI: 10.1007/s00106-023-01354-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/04/2023] [Indexed: 09/14/2023]
Abstract
The combination of positron-emission tomography (PET) with cross-sectional imaging in particular is becoming increasingly important in the diagnosis of head and neck tumors because, in addition to pure anatomy, the metabolic activity of tissue can be visualized and assessed. The combination of PET and computed tomography (CT) is already an established procedure in head and neck tumor patients in some indications, e.g., for primary tumor detection in cancer of unknown primary (CUP) syndrome or also after completed primary radio(chemo)therapy for evaluation of response, especially also with regard to nodal status. In some cases, salvage neck dissection can thus be avoided in the case of PET-negative findings. In the context of primary diagnosis, PET/CT imaging can be used primarily to evaluate distant metastasis. According to current guidelines, PET-based imaging is not (yet) of value in determining the local extent at initial diagnosis. A challenge is the still limited reimbursement by health insurance companies, which currently allow only certain indications, and the still lack of nationwide coverage.
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Affiliation(s)
- Julia P Lingl
- Universitätsklinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Universitätsklinikum Ulm, Frauensteige 12, 89075, Ulm, Deutschland.
- i2SOUL Consortium, Surgical Oncology Ulm, Ulm, Deutschland.
| | - Felix Böhm
- Universitätsklinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Universitätsklinikum Ulm, Frauensteige 12, 89075, Ulm, Deutschland
- i2SOUL Consortium, Surgical Oncology Ulm, Ulm, Deutschland
| | - Patrick J Schuler
- Universitätsklinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Universitätsklinikum Ulm, Frauensteige 12, 89075, Ulm, Deutschland
- i2SOUL Consortium, Surgical Oncology Ulm, Ulm, Deutschland
| | - Thomas K Hoffmann
- Universitätsklinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Universitätsklinikum Ulm, Frauensteige 12, 89075, Ulm, Deutschland
- i2SOUL Consortium, Surgical Oncology Ulm, Ulm, Deutschland
| | - Katharina Deininger
- Klinik für Nuklearmedizin, Universitätsklinikum Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Deutschland
- i2SOUL Consortium, Surgical Oncology Ulm, Ulm, Deutschland
| | - Meinrad Beer
- Diagnostische und Interventionelle Radiologie, Universitätsklinikum Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Deutschland
- i2SOUL Consortium, Surgical Oncology Ulm, Ulm, Deutschland
| | - Ambros J Beer
- Klinik für Nuklearmedizin, Universitätsklinikum Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Deutschland
- i2SOUL Consortium, Surgical Oncology Ulm, Ulm, Deutschland
| | - Wolfgang Thaiss
- Klinik für Nuklearmedizin, Universitätsklinikum Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Deutschland
- Diagnostische und Interventionelle Radiologie, Universitätsklinikum Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Deutschland
- i2SOUL Consortium, Surgical Oncology Ulm, Ulm, Deutschland
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Baumann E, Koller M, Wenz HJ, Wiltfang J, Hertrampf K. Oral cancer awareness campaign in Northern Germany: successful steps to raise awareness for early detection. J Cancer Res Clin Oncol 2023:10.1007/s00432-023-04820-0. [PMID: 37131061 PMCID: PMC10374765 DOI: 10.1007/s00432-023-04820-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Accepted: 04/25/2023] [Indexed: 05/04/2023]
Abstract
PURPOSE Oral cancer is an underestimated health problem, and its existence and the relevant prevention measures are not sufficiently known by the general population. The project thus aimed to develop, implement and evaluate an oral cancer campaign in Northern Germany, and to increase problem awareness on various levels: draw public attention to the tumour by media coverage increase awareness of early detection opportunities for the target group, and raise awareness of carrying out early detection measures by the professional groups involved. METHODS For each level, a campaign concept was developed and documented in terms of content and timing. The identified target group was elderly educationally disadvantaged male citizens ≥ 50 years. The evaluation concept for each level included pre-, post- and process evaluations. RESULTS The campaign was carried out from April 2012 to December 2014. The issue of awareness within the target group was significantly increased. Media coverage showed that regional media adopted the topic of oral cancer and placed it on their published agenda. Furthermore, the continuous involvement of the professional groups over the course of the campaign led to an increased awareness of oral cancer. CONCLUSION The development of the campaign concept with a comprehensive evaluation showed that the target group was successfully reached. The campaign was adapted to the required target group and specific conditions, and was also designed to be context sensitive. It is, therefore, recommended that the development and implementation of an oral cancer campaign on a national level be discussed.
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Affiliation(s)
- Eva Baumann
- Department of Journalism and Communication Research, Hannover University of Music, Drama, and Media, Germany, Expo Plaza 12, 30539, Hannover, Germany
| | - Michael Koller
- Centre for Clinical Studies, University Hospital Regensburg, 93042, Regensburg, Germany
| | - Hans-Jürgen Wenz
- Department of Prosthodontics, Propedeutics and Dental Materials, University Hospital Schleswig-Holstein, Campus Kiel, Arnold-Heller Str. 3, Building B, 24105, Kiel, Germany
| | - Jörg Wiltfang
- Department of Oral and Maxillofacial Surgery, University Hospital Schleswig-Holstein, Campus Kiel, Arnold-Heller Str. 3, Building B, 24105, Kiel, Germany
| | - Katrin Hertrampf
- Department of Oral and Maxillofacial Surgery, University Hospital Schleswig-Holstein, Campus Kiel, Arnold-Heller Str. 3, Building B, 24105, Kiel, Germany.
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[Sexual behavior and prevention of sexually transmitted infections taking the SARS-CoV-2 pandemic into account. Data from a sexual healthcare and medicine center-WIR]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2021; 64:1440-1451. [PMID: 34665268 PMCID: PMC8523933 DOI: 10.1007/s00103-021-03441-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 09/28/2021] [Indexed: 11/04/2022]
Abstract
Hintergrund Anwendungsbezogene Daten zu sexueller Gesundheit und sexuellem Verhalten in unterschiedlich sexuell aktiven Populationen stehen nur begrenzt zur Verfügung, sind aber für Präventions- und Versorgungsstrategien sehr relevant. Das multisektorale Versorgungszentrum WIR – Walk In Ruhr hat aufgrund seiner Besucher*innenstruktur Zugang zu Daten aus diversen Lebenswelten. Ziel der Arbeit Aus verschiedenen WIR-internen Datenquellen sollen populationsbezogene Erkenntnisse zu Alter, Geschlecht, sexueller Orientierung, Sexual- und Risikoverhalten gewonnen und Bedarfe für Prävention abgeleitet werden. Einflüsse der SARS-CoV-2-Pandemie auf das Sexualverhalten sollen durch den Vergleich verschiedener Zeiträume untersucht werden. Methoden Ausgewertete Datenquellen sind der Onlinerisikotest für HIV und STI, die COWIR- und PrEP-Studie sowie die Immunologische Ambulanz und das Gesundheitsamt im WIR. Ergebnis Sexuell übertragbare Infektionen (STI) sind von 2019 auf 2020 trotz Kontaktbeschränkungen gestiegen. Generell haben junge Menschen, Männer, die Sex mit Männern, und Frauen, die Sex mit Frauen haben, ein erhöhtes STI-Risiko aufgrund der gewählten Sexualpraktiken und der Anzahl sexueller Kontakte. Eine hohe Zahl bi- und transsexueller Kontakte ist festzustellen. SARS-CoV‑2 führte zu einer Reduzierung der Sexualkontakte. Sexualpraktiken wurden weiter gelebt. Die STI-Testquote und die Behandlungsrate stiegen an. Diskussion Die Daten aus dem WIR belegen, dass eine junge Klientel mit aktivem Sexualleben erreicht wird. Die Ergebnisse aus Fragebögen und dem Onlinerisikotest zeigen den Zusammenhang von erhöhten positiven STI-Tests mit Sexualverhalten und sexuellen Präferenzen, weshalb spezifische Strategien zu Sexualaufklärung, Prävention, Tests und Therapien erforderlich sind.
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