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Radosa CG, Nadjiri J, Mahnken AH, Bücker A, Heuser LJ, Morhard D, Landwehr P, Berlis A, Katoh M, Reimer P, Schachtner B, Ingrisch M, Paprottka P, Hoffmann RT. Availability of Interventional Oncology in Germany in the Years 2018 and 2019 - Results from a Nationwide Database (DeGIR Registry Data). ROFO-FORTSCHR RONTG 2022; 194:755-761. [PMID: 35211926 DOI: 10.1055/a-1729-0951] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Over the past few decades, radiology has established itself in tumor therapy through interventional oncology including innovative and efficient procedures for minimalinvasive treatment of various tumor entities besides the "classic" therapeutic options such as surgery, chemotherapy and radiotherapy.Aim of this study was to evaluate the extent to which interventional oncology can provide nationwide care using the data from the register of the German Society for Interventional Radiology and Minimally Invasive Therapy (DeGIR registry), which records radiological interventions as part of quality assurance. METHODS The numbers of interventions of participating clinics, which were recorded as part of module D (oncological procedures including TACE or other tumor-specific embolization, ablation, percutaneous tumor therapy) and identified by the DeGIR registry between 2018 and 2019, were analyzed retrospectively. The collected intervention data were evaluated regarding federal states and 40 smaller regions (administrative districts and former administrative districts). RESULTS In 2018, 11 653 oncological interventions in 187 clinics were recorded by the DeGIR registry. In 2019, the number of participating clinics rose to 216 and the number of oncological interventions increased by 6 % to 12 323. The average number of oncological interventions per clinic decreased slightly from 62.5 (2018) to 57.1 (2019). The DeGIR requirement for being certified as a training center was met by 116 clinics in 2018 including 31 clinics with more than 100 interventions and 129 clinics in 2019 including 36 with more than 100 interventions. Oncological interventions have been performed in each of the 40 regions. An average of 599 interventions per region (standard deviation of 414) was recorded in the period between 2018 and 2019. CONCLUSION Based on the distribution of the documented oncological interventions at federal state level as well as the district level, the supply of interventional tumor therapy depends on the geographical location. Therefore, the demand of oncological interventions might not be sufficiently covered in some regions. KEY POINTS · Interventional-oncological tumor therapies are performed throughout Germany. · Looking at the notable geographical differences, the need for interventional oncological procedures does not seem to be sufficiently met.. · In order to improve the comprehensive provision of oncological interventions, the training of interventional radiologists should be promoted further.. CITATION FORMAT · Radosa CG, Nadjiri J, Mahnken AH et al. Availability of Interventional Oncology in Germany in the Years 2018 and 2019 - Results from a Nationwide Database (DeGIR Registry Data). Fortschr Röntgenstr 2022; DOI: 10.1055/a-1729-0951.
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Affiliation(s)
- Christoph Georg Radosa
- Department of Diagnostic and Interventional Radiology, University Hospital Carl Gustav Carus, TU Dresden, Germany
| | - Jonathan Nadjiri
- Department of Interventional Radiology, Klinikum rechts der Isar of the Technical University of Munich, Germany
| | - Andreas H Mahnken
- Diagnostic & Interventional Radiology, Philipps-University Marburg, Germany.,c/o Deutsche Röntgengesellschaft e. V., Board member of the German Society for Interventional Radiology and Microinvasive Therapy (DeGIR), Berlin, Germany
| | - Arno Bücker
- Clinic of Diagnostic and Interventional Radiology, Saarland University Medical Center, Homburg, Germany
| | - Lothar J Heuser
- Diagnostic and Interventional Radiology, Ruhr-Universität Bochum, Germany
| | - Dominik Morhard
- Radiology and Neuroradiology, Leopoldina-Krankenhaus der Stadt Schweinfurt GmbH, Schweinfurt, Germany
| | - Peter Landwehr
- Department for Diagnostic and Interventional Radiology, Diakoniekrankenhaus Henriettenstiftung, Hannover, Germany.,c/o Deutsche Röntgengesellschaft e. V., Board member of the German Society for Interventional Radiology and Microinvasive Therapy (DeGIR), Berlin, Germany
| | - Ansgar Berlis
- Department of Diagnostic and Interventionell Radiology and Neuroradiology, University Hospital Augsburg, Germany.,c/o Deutsche Röntgengesellschaft e. V., Board member of the German Society for Interventional Radiology and Microinvasive Therapy (DeGIR), Berlin, Germany
| | - Marcus Katoh
- Diagnostische und Interventionelle Radiologie, Helios Klinikum Krefeld, Germany.,c/o Deutsche Röntgengesellschaft e. V., Board member of the German Society for Interventional Radiology and Microinvasive Therapy (DeGIR), Berlin, Germany
| | - Peter Reimer
- Zentralinstitut für bildgebende Diagnostik, Städtisches Klinikum Karlsruhe, Germany.,c/o Deutsche Röntgengesellschaft e. V., Board member of the German Society for Interventional Radiology and Microinvasive Therapy (DeGIR), Berlin, Germany
| | - Balthasar Schachtner
- Department of Radiology, Ludwig-Maximilians-Universität München, Munich, Germany.,Member of the German Center for Lung Research (DZL), Comprehensive Pneumology Center (CPC-M), Munich, Germany
| | - Michael Ingrisch
- Department of Radiology, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Philipp Paprottka
- Department of Interventional Radiology, Klinikum rechts der Isar of the Technical University of Munich, Germany.,c/o Deutsche Röntgengesellschaft e. V., Board member of the German Society for Interventional Radiology and Microinvasive Therapy (DeGIR), Berlin, Germany
| | - Ralf-Thorsten Hoffmann
- Department of Diagnostic and Interventional Radiology, University Hospital Carl Gustav Carus, TU Dresden, Germany.,c/o Deutsche Röntgengesellschaft e. V., Board member of the German Society for Interventional Radiology and Microinvasive Therapy (DeGIR), Berlin, Germany
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Polifka I, Agaimy A, Moch H, Hartmann A. [Histological subtypes of renal cell carcinoma : Overview and new developments]. DER PATHOLOGE 2021; 42:294-304. [PMID: 33825093 DOI: 10.1007/s00292-021-00937-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/08/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND The classification of renal cell carcinoma (RCC) has changed remarkably in recent years. OBJECTIVES This is a short overview of the classification of RCC, focusing on new developments. MATERIALS AND METHODS A literature search was performed resulting in an overview of the classification of RCC. Emerging entities were discussed in detail. RESULTS Apart from the RCC subtypes in the WHO classification of 2016, several emerging entities came up over the last few years that are characterized by typical morphology, immunophenotype, and especially specific genetic alterations. CONCLUSION Precise classification of RCC is the key to better prognostic assessment with potential tumor-specific therapy and plays an important role in the recognition of possible association with hereditary tumor syndromes.
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Affiliation(s)
- I Polifka
- Pathologisches Institut, Universitätsklinikum Erlangen, Krankenhausstr. 8-10, 91054, Erlangen, Deutschland
| | - A Agaimy
- Pathologisches Institut, Universitätsklinikum Erlangen, Krankenhausstr. 8-10, 91054, Erlangen, Deutschland
| | - H Moch
- Department für Pathologie und Molekularpathologie, Universitätsspital Zürich, Zürich, Schweiz
| | - A Hartmann
- Pathologisches Institut, Universitätsklinikum Erlangen, Krankenhausstr. 8-10, 91054, Erlangen, Deutschland.
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Observations on Solitary Versus Multiple Isolated Pancreatic Metastases of Renal Cell Carcinoma: Another Indication of a Seed and Soil Mechanism? Cancers (Basel) 2019; 11:cancers11091379. [PMID: 31533220 PMCID: PMC6770877 DOI: 10.3390/cancers11091379] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Revised: 09/02/2019] [Accepted: 09/04/2019] [Indexed: 12/15/2022] Open
Abstract
Isolated pancreas metastases are a rare type of metastasis of renal cell carcinoma, characterized by the presence of pancreatic metastases, while all other organs remain unaffected. In a previous study, we determined arguments from the literature which (a) indicate a systemic–haematogenic metastasis route (uniform distribution of the metastases across the pancreas and independence of the metastatic localization in the pancreas of the side of the renal carcinoma); and (b) postulate a high impact of a seed and soil mechanism (SSM) on isolated pancreatic metastasis of renal cell carcinoma (isPM) as an explanation for exclusive pancreatic metastases, despite a systemic haematogenous tumor cell embolization. The objective of the study presented was to search for further arguments in favor of an SSM with isPM. For that purpose, the factor’s histology, grading, and singular/multiple pancreas metastases were analyzed on the basis of 814 observations published up to 2018. While histology and grading allowed for no conclusions regarding the importance of an SSM, the comparison of singular/multiple pancreas metastases produced arguments in favor of an SSM: 1. The multiple pancreas metastases observed in 38.1% prove that multiple tumor cell embolisms occur with isPM, the exclusive “maturation” of which in the pancreas requires an SSM; 2. The survival rates (SVR), which are consistent with singular and multiple pancreas metastases (despite the higher total tumor load with the latter), prove that the metastasized tumor cells are not able to survive in all other organs because of an SSM, which results in identical SVR when the pancreatic foci are treated adequately.
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[Renal cell carcinoma diagnosis and prognosis within the context of the WHO classification 2016]. Urologe A 2019; 58:1057-1065. [PMID: 31093717 DOI: 10.1007/s00120-019-0952-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Histological classification of renal cell carcinoma (RCC) has become more and more important for clinical management, but relatively few is known regarding the swiftness with which the 2016 World Health Organization (WHO) classification of RCC was adopted in the daily routine diagnostics. AIM To retrospectively review the histological diagnosis of RCC within the context of 2016 WHO classification followed by survival analysis. MATERIAL AND METHODS Retrospective register based analysis of RCC diagnosis between 1998 and 2017 and survival analysis. RESULTS 1440 RCC cases were registered between 1998 and 1917. According to 2016 WHO classification, 77.7% clear cell RCC and 22.3% non-clear cell RCC were diagnosed. A total of 37 rare subtypes were recorded, among those 1% MiT family translocation RCC, 0.35% acquired cystic disease-associated RCC, 0.35% multilocular cystic renal neoplasm of low malignant potential, 0.35% collecting duct carcinoma, 0.3% mucinous tubular and spindle cell carcinoma, 0.1% clear cell papillary RCC and 0.1% RCC with (angio)leiomyomatous stroma. Cox regression analysis showed significant different overall survival and progression-free survival between the histological subtypes. DISCUSSION The complexity of the 2016 WHO classification of RCC put high demands on histopathological diagnostics. At University Medicine Center Rostock morphological distinct RCC entities have been mostly diagnosed by conventional means via hematoxillin and eosin stained slides, but beyond immunohistochemistry additionally molecular techniques were established. The histologic subtyping of RCC according to 2016 WHO classification has prognostic significance and might have predictive significance for unique therapeutic approaches.
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Bezhanova SD. [Tumors of the kidney. The new 2016 WHO classification of tumors of the genitourinary system]. Arkh Patol 2017; 79:48-52. [PMID: 28418358 DOI: 10.17116/patol201779248-52] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The article deals with the innovations available in the 2016 World Health Organization (WHO) classification of renal tumors, which has replaced the previous 2004 WHO classification. The review highlights the key aspects necessary for practicing histopathologists who work in specialized cancer centers or multidisciplinary hospitals diagnosing renal tumors. How to choose a system for determining the malignancy grade of renal tumors is considered separately.
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Affiliation(s)
- S D Bezhanova
- N.N. Blokhin Russian Cancer Research Center, Ministry of Health of Russia, Moscow, Russia
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