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Heil J. SA 7.3 Limited axillary surgery concepts to determine nodal pathologic complete response. Breast 2023. [DOI: 10.1016/s0960-9776(23)00097-8] [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: 03/15/2023] Open
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Pixberg C, Zapatka M, Hlevnjak M, Benedetto S, Suppelna JP, Heil J, Smetanay K, Michel L, Fremd C, Körber V, Rübsam M, Buschhorn L, Heublein S, Schäfgen B, Golatta M, Gomez C, von Au A, Wallwiener M, Wolf S, Dikow N, Schaaf C, Gutjahr E, Allgäuer M, Stenzinger A, Pfütze K, Kirsten R, Hübschmann D, Sinn HP, Jäger D, Trumpp A, Schlenk R, Höfer T, Thewes V, Schneeweiss A, Lichter P. COGNITION: a prospective precision oncology trial for patients with early breast cancer at high risk following neoadjuvant chemotherapy. ESMO Open 2022; 7:100637. [PMID: 36423362 PMCID: PMC9808485 DOI: 10.1016/j.esmoop.2022.100637] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 10/09/2022] [Accepted: 10/18/2022] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND COGNITION (Comprehensive assessment of clinical features, genomics and further molecular markers to identify patients with early breast cancer for enrolment on marker driven trials) is a diagnostic registry trial that employs genomic and transcriptomic profiling to identify biomarkers in patients with early breast cancer with a high risk for relapse after standard neoadjuvant chemotherapy (NACT) to guide genomics-driven targeted post-neoadjuvant therapy. PATIENTS AND METHODS At National Center for Tumor Diseases Heidelberg patients were biopsied before starting NACT, and for patients with residual tumors after NACT additional biopsy material was collected. Whole-genome/exome and transcriptome sequencing were applied on tumor and corresponding blood samples. RESULTS In the pilot phase 255 patients were enrolled, among which 213 were assessable: thereof 48.8% were identified to be at a high risk for relapse following NACT; 86.4% of 81 patients discussed in the molecular tumor board were eligible for a targeted therapy within the interventional multiarm phase II trial COGNITION-GUIDE (Genomics-guided targeted post neoadjuvant therapy in patients with early breast cancer) starting enrolment in Q4/2022. An in-depth longitudinal analysis at baseline and in residual tumor tissue of 16 patients revealed some cases with clonal evolution but largely stable genetic alterations, suggesting restricted selective pressure of broad-acting cytotoxic neoadjuvant chemotherapies. CONCLUSIONS While most precision oncology initiatives focus on metastatic disease, the presented concept offers the opportunity to empower novel therapy options for patients with high-risk early breast cancer in the post-neoadjuvant setting within a biomarker-driven trial and provides the basis to test the value of precision oncology in a curative setting with the overarching goal to increase cure rates.
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Affiliation(s)
- C Pixberg
- National Center for Tumor Diseases (NCT) Heidelberg, a partnership between DKFZ and Heidelberg University Medical Center, Heidelberg, Germany; University Hospital Heidelberg, Heidelberg, Germany
| | - M Zapatka
- National Center for Tumor Diseases (NCT) Heidelberg, a partnership between DKFZ and Heidelberg University Medical Center, Heidelberg, Germany; Division of Molecular Genetics, German Cancer Research Center (DKFZ), Heidelberg, Germany; German Cancer Consortium (DKTK), Heidelberg, Germany
| | - M Hlevnjak
- National Center for Tumor Diseases (NCT) Heidelberg, a partnership between DKFZ and Heidelberg University Medical Center, Heidelberg, Germany; Division of Molecular Genetics, German Cancer Research Center (DKFZ), Heidelberg, Germany; German Cancer Consortium (DKTK), Heidelberg, Germany; Research Group Computational Oncology, Molecular Precision Oncology Program, National Center for Tumor Diseases (NCT) Heidelberg, a partnership between DKFZ and Heidelberg University Medical Center, Heidelberg, Germany
| | - S Benedetto
- Division of Theoretical Systems Biology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - J P Suppelna
- National Center for Tumor Diseases (NCT) Heidelberg, a partnership between DKFZ and Heidelberg University Medical Center, Heidelberg, Germany; University Hospital Heidelberg, Heidelberg, Germany
| | - J Heil
- Department of Obstetrics and Gynecology, Medical School, University of Heidelberg, Heidelberg, Germany
| | - K Smetanay
- National Center for Tumor Diseases (NCT) Heidelberg, a partnership between DKFZ and Heidelberg University Medical Center, Heidelberg, Germany; University Hospital Heidelberg, Heidelberg, Germany; Department of Obstetrics and Gynecology, Medical School, University of Heidelberg, Heidelberg, Germany
| | - L Michel
- National Center for Tumor Diseases (NCT) Heidelberg, a partnership between DKFZ and Heidelberg University Medical Center, Heidelberg, Germany; University Hospital Heidelberg, Heidelberg, Germany
| | - C Fremd
- National Center for Tumor Diseases (NCT) Heidelberg, a partnership between DKFZ and Heidelberg University Medical Center, Heidelberg, Germany; University Hospital Heidelberg, Heidelberg, Germany; Department of Medical Oncology, National Center for Tumor Diseases (NCT) Heidelberg, a partnership between DKFZ and Heidelberg University Medical Center, University Hospital Heidelberg, Heidelberg, Germany
| | - V Körber
- Division of Theoretical Systems Biology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - M Rübsam
- Research Group Computational Oncology, Molecular Precision Oncology Program, National Center for Tumor Diseases (NCT) Heidelberg, a partnership between DKFZ and Heidelberg University Medical Center, Heidelberg, Germany
| | - L Buschhorn
- National Center for Tumor Diseases (NCT) Heidelberg, a partnership between DKFZ and Heidelberg University Medical Center, Heidelberg, Germany; University Hospital Heidelberg, Heidelberg, Germany
| | - S Heublein
- National Center for Tumor Diseases (NCT) Heidelberg, a partnership between DKFZ and Heidelberg University Medical Center, Heidelberg, Germany; University Hospital Heidelberg, Heidelberg, Germany; Department of Obstetrics and Gynecology, Medical School, University of Heidelberg, Heidelberg, Germany
| | - B Schäfgen
- Department of Obstetrics and Gynecology, Medical School, University of Heidelberg, Heidelberg, Germany
| | - M Golatta
- Department of Obstetrics and Gynecology, Medical School, University of Heidelberg, Heidelberg, Germany
| | - C Gomez
- Department of Obstetrics and Gynecology, Medical School, University of Heidelberg, Heidelberg, Germany
| | - A von Au
- Department of Obstetrics and Gynecology, Medical School, University of Heidelberg, Heidelberg, Germany
| | - M Wallwiener
- Department of Obstetrics and Gynecology, Medical School, University of Heidelberg, Heidelberg, Germany
| | - S Wolf
- Genomics and Proteomics Core Facility, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - N Dikow
- Institute of Human Genetics, Heidelberg University Hospital, Heidelberg, Germany
| | - C Schaaf
- Institute of Human Genetics, Heidelberg University Hospital, Heidelberg, Germany
| | - E Gutjahr
- Department of General Pathology, University Hospital Heidelberg, Heidelberg, Germany
| | - M Allgäuer
- Department of General Pathology, University Hospital Heidelberg, Heidelberg, Germany
| | - A Stenzinger
- Department of General Pathology, University Hospital Heidelberg, Heidelberg, Germany
| | - K Pfütze
- National Center for Tumor Diseases (NCT) Heidelberg, a partnership between DKFZ and Heidelberg University Medical Center, Heidelberg, Germany
| | - R Kirsten
- Liquid Biobank, National Center for Tumor Diseases (NCT) Heidelberg, a partnership between DKFZ and Heidelberg University Medical Center, Heidelberg, Germany
| | - D Hübschmann
- German Cancer Consortium (DKTK), Heidelberg, Germany; Research Group Computational Oncology, Molecular Precision Oncology Program, National Center for Tumor Diseases (NCT) Heidelberg, a partnership between DKFZ and Heidelberg University Medical Center, Heidelberg, Germany; Heidelberg Institute for Stem Cell Technology and Experimental Medicine (HI-STEM gGmbH), Heidelberg, Germany
| | - H-P Sinn
- Department of General Pathology, University Hospital Heidelberg, Heidelberg, Germany
| | - D Jäger
- Department of Medical Oncology, National Center for Tumor Diseases (NCT) Heidelberg, a partnership between DKFZ and Heidelberg University Medical Center, University Hospital Heidelberg, Heidelberg, Germany
| | - A Trumpp
- Heidelberg Institute for Stem Cell Technology and Experimental Medicine (HI-STEM gGmbH), Heidelberg, Germany; Division of Stem Cells and Cancer, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - R Schlenk
- Department of Medical Oncology, National Center for Tumor Diseases (NCT) Heidelberg, a partnership between DKFZ and Heidelberg University Medical Center, University Hospital Heidelberg, Heidelberg, Germany; Department of Hematology, Oncology and Rheumatology, Heidelberg University Hospital, Heidelberg, Germany; NCT Trial Center, National Center for Tumor Diseases (NCT) Heidelberg, a partnership between DKFZ and Heidelberg University Medical Center and DKFZ, Heidelberg, Germany
| | - T Höfer
- Division of Theoretical Systems Biology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - V Thewes
- National Center for Tumor Diseases (NCT) Heidelberg, a partnership between DKFZ and Heidelberg University Medical Center, Heidelberg, Germany; University Hospital Heidelberg, Heidelberg, Germany; Division of Molecular Genetics, German Cancer Research Center (DKFZ), Heidelberg, Germany; German Cancer Consortium (DKTK), Heidelberg, Germany
| | - A Schneeweiss
- National Center for Tumor Diseases (NCT) Heidelberg, a partnership between DKFZ and Heidelberg University Medical Center, Heidelberg, Germany; University Hospital Heidelberg, Heidelberg, Germany; German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - P Lichter
- National Center for Tumor Diseases (NCT) Heidelberg, a partnership between DKFZ and Heidelberg University Medical Center, Heidelberg, Germany; Division of Molecular Genetics, German Cancer Research Center (DKFZ), Heidelberg, Germany; German Cancer Consortium (DKTK), Heidelberg, Germany.
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Korenblik R, van Zon JFJA, Olij B, Heil J, Dewulf MJL, Neumann UP, Olde Damink SWM, Binkert CA, Schadde E, van der Leij C, van Dam RM, van Baardewijk LJ, Barbier L, Binkert CA, Billingsley K, Björnsson B, Andorrà EC, Arslan B, Baclija I, Bemelmans MHA, Bent C, de Boer MT, Bokkers RPH, de Boo DW, Breen D, Breitenstein S, Bruners P, Cappelli A, Carling U, Robert MCI, Chan B, De Cobelli F, Choi J, Crawford M, Croagh D, van Dam RM, Deprez F, Detry O, Dewulf MJL, Díaz-Nieto R, Dili A, Erdmann JI, Font JC, Davis R, Delle M, Fernando R, Fisher O, Fouraschen SMG, Fretland ÅA, Fundora Y, Gelabert A, Gerard L, Gobardhan P, Gómez F, Guiliante F, Grünberger T, Grochola LF, Grünhagen DJ, Guitart J, Hagendoorn J, Heil J, Heise D, Herrero E, Hess G, Hilal MA, Hoffmann M, Iezzi R, Imani F, Inmutto N, James S, Borobia FJG, Jovine E, Kalil J, Kingham P, Kollmar O, Kleeff J, van der Leij C, Lopez-Ben S, Macdonald A, Meijerink M, Korenblik R, Lapisatepun W, Leclercq WKG, Lindsay R, Lucidi V, Madoff DC, Martel G, Mehrzad H, Menon K, Metrakos P, Modi S, Moelker A, Montanari N, Moragues JS, Navinés-López J, Neumann UP, Nguyen J, Peddu P, Primrose JN, Olde Damink SWM, Qu X, Raptis DA, Ratti F, Ryan S, Ridouani F, Rinkes IHMB, Rogan C, Ronellenfitsch U, Serenari M, Salik A, Sallemi C, Sandström P, Martin ES, Sarría L, Schadde E, Serrablo A, Settmacher U, Smits J, Smits MLJ, Snitzbauer A, Soonawalla Z, Sparrelid E, Spuentrup E, Stavrou GA, Sutcliffe R, Tancredi I, Tasse JC, Teichgräber U, Udupa V, Valenti DA, Vass D, Vogl TJ, Wang X, White S, De Wispelaere JF, Wohlgemuth WA, Yu D, Zijlstra IJAJ. Resectability of bilobar liver tumours after simultaneous portal and hepatic vein embolization versus portal vein embolization alone: meta-analysis. BJS Open 2022; 6:6844022. [PMID: 36437731 PMCID: PMC9702575 DOI: 10.1093/bjsopen/zrac141] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 09/09/2022] [Accepted: 10/05/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Many patients with bi-lobar liver tumours are not eligible for liver resection due to an insufficient future liver remnant (FLR). To reduce the risk of posthepatectomy liver failure and the primary cause of death, regenerative procedures intent to increase the FLR before surgery. The aim of this systematic review is to provide an overview of the available literature and outcomes on the effectiveness of simultaneous portal and hepatic vein embolization (PVE/HVE) versus portal vein embolization (PVE) alone. METHODS A systematic literature search was conducted in PubMed, Web of Science, and Embase up to September 2022. The primary outcome was resectability and the secondary outcome was the FLR volume increase. RESULTS Eight studies comparing PVE/HVE with PVE and six retrospective PVE/HVE case series were included. Pooled resectability within the comparative studies was 75 per cent in the PVE group (n = 252) versus 87 per cent in the PVE/HVE group (n = 166, OR 1.92 (95% c.i., 1.13-3.25)) favouring PVE/HVE (P = 0.015). After PVE, FLR hypertrophy between 12 per cent and 48 per cent (after a median of 21-30 days) was observed, whereas growth between 36 per cent and 67 per cent was reported after PVE/HVE (after a median of 17-31 days). In the comparative studies, 90-day primary cause of death was similar between groups (2.5 per cent after PVE versus 2.2 per cent after PVE/HVE), but a higher 90-day primary cause of death was reported in single-arm PVE/HVE cohort studies (6.9 per cent, 12 of 175 patients). CONCLUSION Based on moderate/weak evidence, PVE/HVE seems to increase resectability of bi-lobar liver tumours with a comparable safety profile. Additionally, PVE/HVE resulted in faster and more pronounced hypertrophy compared with PVE alone.
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Affiliation(s)
- Remon Korenblik
- Correspondence to: R. K., Universiteigssingel 50 (room 5.452) 6229 ER Maastricht, The Netherlands (e-mail: ); R. M. v. D., Maastricht UMC+, Dept. of Surgery, Level 4, PO Box 5800, 6202 AZ Maastricht, The Netherlands (e-mail: )
| | - Jasper F J A van Zon
- Department of Surgery, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Bram Olij
- Department of Surgery, Maastricht University Medical Center, Maastricht, The Netherlands,GROW—Department of Surgery, School for Oncology and Reproduction, Maastricht University, Maastricht, The Netherlands,Department of General, Visceral and Transplant Surgery, University Hospital RWTH Aachen, Aachen, Germany
| | - Jan Heil
- Department of General, Visceral and Transplant Surgery, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Maxime J L Dewulf
- Department of Surgery, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Ulf P Neumann
- Department of Surgery, Maastricht University Medical Center, Maastricht, The Netherlands,Department of General, Visceral and Transplant Surgery, University Hospital RWTH Aachen, Aachen, Germany
| | - Steven W M Olde Damink
- Department of Surgery, Maastricht University Medical Center, Maastricht, The Netherlands,Department of General, Visceral and Transplant Surgery, University Hospital RWTH Aachen, Aachen, Germany,NUTRIM—Department of Surgery, School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
| | - Christoph A Binkert
- Department of Radiology, Cantonal Hospital Winterthur, Winterthur, Switzerland
| | - Erik Schadde
- Department of General, Visceral and Transplant Surgery, Klinik Hirslanden, Zurich, Switzerland,Department of General, Visceral and Transplant Surgery, Hirslanden Klink St. Anna Luzern, Luzern, Switzerland
| | | | - Ronald M van Dam
- Correspondence to: R. K., Universiteigssingel 50 (room 5.452) 6229 ER Maastricht, The Netherlands (e-mail: ); R. M. v. D., Maastricht UMC+, Dept. of Surgery, Level 4, PO Box 5800, 6202 AZ Maastricht, The Netherlands (e-mail: )
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Paepke S, Klein E, Andrulat A, Ankel C, Bauer L, Faridi A, Fink V, Gerber-Schäfer C, Gschwantler-Kaulich D, Heil J, Kümmel S, Ohlinger R, Thill M. Mesh-Pocket Supported Prepectoral Direct-to-Implant Breast Reconstruction: Preliminary Results of a Prospective Analysis. Eur J Cancer 2022. [DOI: 10.1016/s0959-8049(22)01378-8] [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: 11/19/2022]
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Paepke S, Andrulat A, Ankel C, Bauer L, Baumann K, Blohmer J, Faridi A, Fink V, Gerber-Schäfer C, Gschwantler-Kaulich D, Heil J, Kümmel S, Mau C, Kossmann-Meiré A, Ohlinger R, Thill M. Underestimated risk of involved margins in Skin (SMM)- and Nipple Sparing Mastectomies (NSM) – Data and Multimodal Approach for Improvement. Eur J Cancer 2022. [DOI: 10.1016/s0959-8049(22)01379-x] [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: 11/19/2022]
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Korenblik R, Olij B, Aldrighetti LA, Hilal MA, Ahle M, Arslan B, van Baardewijk LJ, Baclija I, Bent C, Bertrand CL, Björnsson B, de Boer MT, de Boer SW, Bokkers RPH, Rinkes IHMB, Breitenstein S, Bruijnen RCG, Bruners P, Büchler MW, Camacho JC, Cappelli A, Carling U, Chan BKY, Chang DH, Choi J, Font JC, Crawford M, Croagh D, Cugat E, Davis R, De Boo DW, De Cobelli F, De Wispelaere JF, van Delden OM, Delle M, Detry O, Díaz-Nieto R, Dili A, Erdmann JI, Fisher O, Fondevila C, Fretland Å, Borobia FG, Gelabert A, Gérard L, Giuliante F, Gobardhan PD, Gómez F, Grünberger T, Grünhagen DJ, Guitart J, Hagendoorn J, Heil J, Heise D, Herrero E, Hess GF, Hoffmann MH, Iezzi R, Imani F, Nguyen J, Jovine E, Kalff JC, Kazemier G, Kingham TP, Kleeff J, Kollmar O, Leclercq WKG, Ben SL, Lucidi V, MacDonald A, Madoff DC, Manekeller S, Martel G, Mehrabi A, Mehrzad H, Meijerink MR, Menon K, Metrakos P, Meyer C, Moelker A, Modi S, Montanari N, Navines J, Neumann UP, Peddu P, Primrose JN, Qu X, Raptis D, Ratti F, Ridouani F, Rogan C, Ronellenfitsch U, Ryan S, Sallemi C, Moragues JS, Sandström P, Sarriá L, Schnitzbauer A, Serenari M, Serrablo A, Smits MLJ, Sparrelid E, Spüntrup E, Stavrou GA, Sutcliffe RP, Tancredi I, Tasse JC, Udupa V, Valenti D, Fundora Y, Vogl TJ, Wang X, White SA, Wohlgemuth WA, Yu D, Zijlstra IAJ, Binkert CA, Bemelmans MHA, van der Leij C, Schadde E, van Dam RM. Dragon 1 Protocol Manuscript: Training, Accreditation, Implementation and Safety Evaluation of Portal and Hepatic Vein Embolization (PVE/HVE) to Accelerate Future Liver Remnant (FLR) Hypertrophy. Cardiovasc Intervent Radiol 2022; 45:1391-1398. [PMID: 35790566 PMCID: PMC9458562 DOI: 10.1007/s00270-022-03176-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 05/08/2022] [Indexed: 12/02/2022]
Abstract
STUDY PURPOSE The DRAGON 1 trial aims to assess training, implementation, safety and feasibility of combined portal- and hepatic-vein embolization (PVE/HVE) to accelerate future liver remnant (FLR) hypertrophy in patients with borderline resectable colorectal cancer liver metastases. METHODS The DRAGON 1 trial is a worldwide multicenter prospective single arm trial. The primary endpoint is a composite of the safety of PVE/HVE, 90-day mortality, and one year accrual monitoring of each participating center. Secondary endpoints include: feasibility of resection, the used PVE and HVE techniques, FLR-hypertrophy, liver function (subset of centers), overall survival, and disease-free survival. All complications after the PVE/HVE procedure are documented. Liver volumes will be measured at week 1 and if applicable at week 3 and 6 after PVE/HVE and follow-up visits will be held at 1, 3, 6, and 12 months after the resection. RESULTS Not applicable. CONCLUSION DRAGON 1 is a prospective trial to assess the safety and feasibility of PVE/HVE. Participating study centers will be trained, and procedures standardized using Work Instructions (WI) to prepare for the DRAGON 2 randomized controlled trial. Outcomes should reveal the accrual potential of centers, safety profile of combined PVE/HVE and the effect of FLR-hypertrophy induction by PVE/HVE in patients with CRLM and a small FLR. TRIAL REGISTRATION Clinicaltrials.gov: NCT04272931 (February 17, 2020). Toestingonline.nl: NL71535.068.19 (September 20, 2019).
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Affiliation(s)
- R Korenblik
- GROW School for Oncology and Developmental Biology, Maastricht University, Maastricht Universiteitssingel 40 room 5.452, 6229 ET, Maastricht, The Netherlands.
- Department of Surgery, Maastricht University Medical Center, Maastricht, The Netherlands.
| | - B Olij
- GROW School for Oncology and Developmental Biology, Maastricht University, Maastricht Universiteitssingel 40 room 5.452, 6229 ET, Maastricht, The Netherlands
- Department of Surgery, Maastricht University Medical Center, Maastricht, The Netherlands
| | | | - M Abu Hilal
- Department of Surgery, Fondazione Poliambulanza, Brescia, Italy
| | - M Ahle
- Deparment of Radiology, University Hospital, Linköping, Sweden
| | - B Arslan
- Department of Radiology, Rush University Medical Center, Chicago, USA
| | - L J van Baardewijk
- Department of Radiology, Maxima Medisch Centrum, Eindhoven, The Netherlands
| | - I Baclija
- Department of Radiology, Clinic Favoriten, Vienna, Austria
| | - C Bent
- Department of Radiology, Bournemouth and Christuchurch, The Royal Bournemouth and Christchurch Hospitals, Bournemouth and Christuchurch, UK
| | - C L Bertrand
- Department of Surgery, CHU UCLouvain Namur, Namur, Belgium
| | - B Björnsson
- Department of Surgery, Biomedical and Clinical Sciences, Linköping University Hospital, Linköping, Sweden
| | - M T de Boer
- Department of Surgery, University Medical Center Groningen, Groningen, The Netherlands
| | - S W de Boer
- Deparment of Radiology and Nuclear Medicine, Maastricht University Medical Center, Maastricht, The Netherlands
| | - R P H Bokkers
- Department of Radiology, University Medical Center Groningen, Groningen, The Netherlands
| | - I H M Borel Rinkes
- Department of Surgery, University Medical Center Utrecht, Utrecht, The Netherlands
| | - S Breitenstein
- Department of General and Visceral Surgery, Cantonal Hospital Winterthur, Winterthur, Switzerland
| | - R C G Bruijnen
- Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - P Bruners
- Department of Radiology, University Hospital Aachen, Aachen, Germany
| | - M W Büchler
- Department of Surgery, University Hospital Heidelberg, Heidelberg, Germany
| | - J C Camacho
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, USA
| | - A Cappelli
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Sant'Orsola-Malpighi Hospital, Bologna, Italy
| | - U Carling
- Department of Radiology, University Hospital Oslo, Oslo, Norway
| | - B K Y Chan
- Department of Surgery, Aintree University Hospitals NHS, Liverpool, UK
| | - D H Chang
- Department of Radiology, University Hospital Heidelberg, Heidelberg, Germany
| | - J Choi
- Department of Surgery, Western Health Footscray, Footscray, Australia
| | - J Codina Font
- Department of Radiology, University Hospital Dr. Josep Trueta de Girona, Girona, Spain
| | - M Crawford
- Department of Surgery, Royal Prince Alfred Hospital, Camperdown, Australia
| | - D Croagh
- Department of Surgery, Monash Health, Clayton, Australia
| | - E Cugat
- Department of Surgery, University Hospital Germans Trias I Pujol, Badalona, Spain
| | - R Davis
- Department of Radiology, Aintree University Hospitals NHS, Liverpool, UK
| | - D W De Boo
- Department of Radiology, Monash Health, Clayton, Australia
| | - F De Cobelli
- Department of Radiology, Ospedale San Raffaele, Milan, Italy
| | | | - O M van Delden
- Department of Radiology, Amsterdam University Medical Centers Location AMC, Amsterdam, The Netherlands
| | - M Delle
- Department of Radiology, Karolinska University Hospital, Stockholm, Sweden
| | - O Detry
- Department of Surgery, CHU de Liège, Liège, Belgium
| | - R Díaz-Nieto
- Department of Surgery, Aintree University Hospitals NHS, Liverpool, UK
| | - A Dili
- Department of Surgery, CHU UCLouvain Namur, Namur, Belgium
| | - J I Erdmann
- Department of Surgery, Amsterdam University Medical Centers Location AMC, Amsterdam, The Netherlands
| | - O Fisher
- Department of Surgery, Royal Prince Alfred Hospital, Camperdown, Australia
| | - C Fondevila
- Department of Surgery, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Å Fretland
- Department of Surgery, University Hospital Oslo, Oslo, Norway
| | - F Garcia Borobia
- Department of Surgery, Hospital Parc Taulí de Sabadell, Sabadell, Spain
| | - A Gelabert
- Department of Radiology, Hospital Parc Taulí de Sabadell, Sabadell, Spain
- Department of Radiology, University Hospital Mútua Terassa, Terassa, Spain
| | - L Gérard
- Department of Radiology, CHU de Liège, Liège, Belgium
| | - F Giuliante
- Department of Surgery, Gemelli University Hospital Rome, Rome, Italy
| | - P D Gobardhan
- Department of Surgery, Amphia, Breda, The Netherlands
| | - F Gómez
- Department of Radiology, Hospital Clínic de Barcelona, Barcelona, Spain
| | - T Grünberger
- Department of Surgery, HPB Center Vienna Health Network, Clinic Favoriten, Vienna, Austria
| | - D J Grünhagen
- Department of Surgery, Erasmus Medisch Centrum, Rotterdam, The Netherlands
| | - J Guitart
- Department of Radiology, University Hospital Mútua Terassa, Terassa, Spain
| | - J Hagendoorn
- Department of Surgery, University Medical Center Utrecht, Utrecht, The Netherlands
| | - J Heil
- Department of Surgery, University Hospital Frankfurt, Frankfurt, Germany
| | - D Heise
- Department of General, Visceral and Transplant Surgery, University Hospital Aachen, Aachen, Germany
| | - E Herrero
- Department of Surgery, University Hospital Mútua Terassa, Terassa, Spain
| | - G F Hess
- Department of Surgery, Clarunis University Hospital, Basel, Switzerland
| | - M H Hoffmann
- Department of Radiology, St. Clara Spital, Basel, Switzerland
| | - R Iezzi
- Department of Radiology, Gemelli University Hospital, Rome, Italy
| | - F Imani
- Department of Radiology, Amphia, Breda, The Netherlands
| | - J Nguyen
- Department of Radiology, Western Health Footscray, Footscray, Australia
| | - E Jovine
- Department of Surgery, Ospedale Maggiore di Bologna, Bologna, Italy
| | - J C Kalff
- Department of Surgery, University Hospital Bonn, Bonn, Germany
| | - G Kazemier
- Department of Surgery, Amsterdam University Medical Centers Location VU, Amsterdam, The Netherlands
| | - T P Kingham
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, USA
| | - J Kleeff
- Department of Surgery, University Hospital Halle (Saale), Halle, Germany
| | - O Kollmar
- Department of Surgery, Clarunis University Hospital, Basel, Switzerland
| | - W K G Leclercq
- Department of Surgery, Maxima Medisch Centrum, Eindhoven, The Netherlands
| | - S Lopez Ben
- Department of Surgery, University Hospital Dr. Josep Trueta de Girona, Girona, Spain
| | - V Lucidi
- Department of Surgery, Hôpital Erasme, Brussels, Belgium
| | - A MacDonald
- Department of Radiology, Oxford University Hospital NHS, Oxford, UK
| | - D C Madoff
- Department of Radiology, Yale School of Medicine, New Haven, USA
| | - S Manekeller
- Department of Surgery, University Hospital Bonn, Bonn, Germany
| | - G Martel
- Department of Surgery, The Ottawa Hospital, Ottawa, Canada
| | - A Mehrabi
- Department of Surgery, University Hospital Heidelberg, Heidelberg, Germany
| | - H Mehrzad
- Department of Radiology, Queen Elizabeth Hospital Birmingham NHS, Birmingham, UK
| | - M R Meijerink
- Department of Radiology, Amsterdam University Medical Centers Location VU, Amsterdam, The Netherlands
| | - K Menon
- Department of Surgery, King's College Hospital NHS, London, UK
| | - P Metrakos
- Department of Surgery, McGill University Health Centre, Montréal, Canada
| | - C Meyer
- Department of Radiology, University Hospital Bonn, Bonn, Germany
| | - A Moelker
- Department of Radiology and Nuclear Medicine, Erasmus Medisch Centrum, Rotterdam, The Netherlands
| | - S Modi
- Department of Radiology, University Hospital Southampton NHS, Southampton, UK
| | - N Montanari
- Department of Radiology, Ospedale Maggiore Di Bologna, Bologna, Italy
| | - J Navines
- Department of Surgery, University Hospital Germans Trias I Pujol, Badalona, Spain
| | - U P Neumann
- Department of Surgery, Maastricht University Medical Center, Maastricht, The Netherlands
- Department of General, Visceral and Transplant Surgery, University Hospital Aachen, Aachen, Germany
| | - P Peddu
- Department of Radiology, King's College Hospital NHS, London, UK
| | - J N Primrose
- Department of Surgery, University Hospital Southampton NHS, Southampton, UK
| | - X Qu
- Department of Radiology, Zhongshan Hospital, Fundan University, Shanghai, China
| | - D Raptis
- Department of Surgery, Royal Free Hospital NHS, London, UK
| | - F Ratti
- Department of Surgery, Ospedale San Raffaele, Milan, Italy
| | - F Ridouani
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, USA
| | - C Rogan
- Department of Radiology, Royal Prince Alfred Hospital, Camperdown, Australia
| | - U Ronellenfitsch
- Department of Surgery, University Hospital Halle (Saale), Halle, Germany
| | - S Ryan
- Department of Radiology, The Ottawa Hospital, Ottawa, Canada
| | - C Sallemi
- Department of Radiology, Fondazione Poliambulanza, Brescia, Italy
| | - J Sampere Moragues
- Department of Radiology, University Hospital Germans Trias I Pujol, Badalona, Spain
| | - P Sandström
- Department of Surgery, Biomedical and Clinical Sciences, Linköping University Hospital, Linköping, Sweden
| | - L Sarriá
- Department of Radiology, University Hospital Miguel Servet, Saragossa, Spain
| | - A Schnitzbauer
- Department of Surgery, University Hospital Frankfurt, Frankfurt, Germany
| | - M Serenari
- Department of Surgery, General Surgery and Transplant Unit, IRCCS Azienda Ospedaliero- Universitaria di Bologna, Sant'Orsola-Malpighi Hospital, Bologna, Italy
| | - A Serrablo
- Department of Surgery, University Hospital Miguel Servet, Saragossa, Spain
| | - M L J Smits
- Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - E Sparrelid
- Department of Surgery, Karolinska University Hospital, Stockholm, Sweden
| | - E Spüntrup
- Department of Radiology, Klinikum Saarbrücken gGmbH, Saarbrücken, Germany
| | - G A Stavrou
- Department of Surgery, Klinikum Saarbrücken gGmbH, Saarbrücken, Germany
| | - R P Sutcliffe
- Department of Surgery, Queen Elizabeth Hospital Birmingham NHS, Birmingham, UK
| | - I Tancredi
- Department of Radiology, Hôpital Erasme, Brussels, Belgium
| | - J C Tasse
- Department of Radiology, Rush University Medical Center, Chicago, USA
| | - V Udupa
- Department of Surgery, Oxford University Hospital NHS, Oxford, UK
| | - D Valenti
- Department of Radiology, McGill University Health Centre, Montréal, Canada
| | - Y Fundora
- Department of Surgery, Hospital Clínic de Barcelona, Barcelona, Spain
| | - T J Vogl
- Department of Radiology, University Hosptital Frankfurt, Frankfurt, Germany
| | - X Wang
- Department of Surgery, Zhongshan Hospital, Fundan University, Shanghai, China
| | - S A White
- Department of Surgery, Newcastle Upon Tyne Hospitals NHS, Newcastle upon Tyne, UK
| | - W A Wohlgemuth
- Department of Radiology, University Hospital Halle (Saale), Halle, Germany
| | - D Yu
- Department of Radiology, Royal Free Hospital NHS, London, UK
| | - I A J Zijlstra
- Department of Radiology, Amsterdam University Medical Centers Location VU, Amsterdam, The Netherlands
| | - C A Binkert
- Department of Radiology, Cantonal Hospital Winterthur, Winterthur, Switzerland
| | - M H A Bemelmans
- Department of Surgery, Maastricht University Medical Center, Maastricht, The Netherlands
- Department of General, Visceral and Transplant Surgery, University Hospital Aachen, Aachen, Germany
| | - C van der Leij
- Deparment of Radiology and Nuclear Medicine, Maastricht University Medical Center, Maastricht, The Netherlands
| | - E Schadde
- Department of General and Visceral Surgery, Cantonal Hospital Winterthur, Winterthur, Switzerland
- Department of Surgery, Rush University Medical Center Chicago, Chicago, USA
| | - R M van Dam
- GROW School for Oncology and Developmental Biology, Maastricht University, Maastricht Universiteitssingel 40 room 5.452, 6229 ET, Maastricht, The Netherlands.
- Department of Surgery, Maastricht University Medical Center, Maastricht, The Netherlands.
- Department of General, Visceral and Transplant Surgery, University Hospital Aachen, Aachen, Germany.
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7
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Forster T, Hommertgen A, Häfner M, Arians N, Laila K, Harrabi S, Schlampp I, Köhler C, Heinrich V, Weidner N, Hüsing J, Golatta M, Sohn C, Heil J, Hof H, Krug D, Debus J, Hoerner-Rieber J. Quality of Life After Simultaneously Integrated Boost With Intensity-Modulated vs. Conventional Radiotherapy Followed by Sequential Boost for Adjuvant Treatment of Breast Cancer: 2-Year Results of the Multicenter Randomized IMRT-MC2 Trial. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.105] [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: 11/29/2022]
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8
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Heil J, Abraham S, Eckardt C, Laske J, Beissert S, Günther C. Bullöses Sweet-Syndrom nach einem Zeckenstich. Aktuelle Dermatologie 2021. [DOI: 10.1055/a-1429-9757] [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: 10/21/2022]
Abstract
ZusammenfassungWir berichten über einen Patienten, der eine Woche nach einem Zeckenstich Fieber und Papulovesikel entwickelte. Eine disseminierte Borrelien-Infektion sowie eine blasenbildende Erkrankung konnte ausgeschlossen werden. Sowohl klinisch als auch histologisch bestätigte sich ein bullöses Sweet-Syndrom, sodass eine systemische Steroidtherapie begonnen wurde. Darunter besserten sich die Beschwerden des Patienten rasch.Die Umfelddiagnostik ergab weder Hinweise auf eine hämatologische Erkrankung noch auf eine Medikamenteneinnahme als Auslöser. Dieser Fall deutet darauf hin, dass auch Arthropodenstiche als Trigger für ein Sweet-Syndrom in Betracht gezogen werden können.
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Affiliation(s)
- J. Heil
- Klinik und Poliklinik für Dermatologie, Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden
| | - S. Abraham
- Klinik und Poliklinik für Dermatologie, Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden
| | - C. Eckardt
- Klinik und Poliklinik für Dermatologie, Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden
| | - J. Laske
- Klinik und Poliklinik für Dermatologie, Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden
| | - S. Beissert
- Klinik und Poliklinik für Dermatologie, Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden
| | - C. Günther
- Klinik und Poliklinik für Dermatologie, Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden
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9
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Fitzal F, Bolliger M, Dunkler D, Gambone L, Heil J, Riedel F, de Boniface J, André C, Matrai Z, Pukancsik D, Paulinelli R, Ostapenko V, Burneckis A, Ostapenko A, Ostapenko E, Meani F, Harder Y, Bonollo M, Alberti A, Tausch C, Papassotiropoulos B, Helfgott R, Heck D, Fehrer H, Acko M, Schrenk P, Montagna G, Trapp E, Pristauz G, Paliczek C, Blohmer J, Steffen S, Romics L, Morrow E, Lorenz K, Fehr M, Ritter M, Weber W. Retrospective multicenter analysis comparing conventional with oncoplastic breast conservation: oncologic and surgical outcome in women with high risk breast cancer from the OPBC-01/iTOP2 study. Breast 2021. [DOI: 10.1016/s0960-9776(21)00222-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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10
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Heil J. Breast surgery after neoadjuvant treatment. Breast 2021. [DOI: 10.1016/s0960-9776(21)00068-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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11
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Heil J, Korenblik R, Heid F, Bechstein WO, Bemelmans M, Binkert C, Björnsson B, Breitenstein S, Detry O, Dili A, Dondelinger RF, Gerard L, Giménez-Maurel T, Guiu B, Heise D, Hertl M, Kalil JA, Klein JJ, Lakoma A, Neumann UP, Olij B, Pappas SG, Sandström P, Schnitzbauer A, Serrablo A, Tasse J, Van der Leij C, Metrakos P, Van Dam R, Schadde E. Preoperative portal vein or portal and hepatic vein embolization: DRAGON collaborative group analysis. Br J Surg 2021; 108:834-842. [PMID: 33661306 DOI: 10.1093/bjs/znaa149] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 10/20/2020] [Accepted: 11/30/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND The extent of liver resection for tumours is limited by the expected functional reserve of the future liver remnant (FRL), so hypertrophy may be induced by portal vein embolization (PVE), taking 6 weeks or longer for growth. This study assessed the hypothesis that simultaneous embolization of portal and hepatic veins (PVE/HVE) accelerates hypertrophy and improves resectability. METHODS All centres of the international DRAGON trials study collaborative were asked to provide data on patients who had PVE/HVE or PVE on 2016-2019 (more than 5 PVE/HVE procedures was a requirement). Liver volumetry was performed using OsiriX MD software. Multivariable analysis was performed for the endpoints of resectability rate, FLR hypertrophy and major complications using receiver operating characteristic (ROC) statistics, regression, and Kaplan-Meier analysis. RESULTS In total, 39 patients had undergone PVE/HVE and 160 had PVE alone. The PVE/HVE group had better hypertrophy than the PVE group (59 versus 48 per cent respectively; P = 0.020) and resectability (90 versus 68 per cent; P = 0.007). Major complications (26 versus 34 per cent; P = 0.550) and 90-day mortality (3 versus 16 per cent respectively, P = 0.065) were comparable. Multivariable analysis confirmed that these effects were independent of confounders. CONCLUSION PVE/HVE achieved better FLR hypertrophy and resectability than PVE in this collaborative experience.
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Affiliation(s)
- J Heil
- Institute of Physiology, University of Zurich, Zurich, Switzerland.,Department of General, Visceral and Transplant Surgery, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt, Germany
| | - R Korenblik
- GROW - School for Oncology and Developmental Biology, Maastricht University, Maastricht, the Netherlands.,Department of Surgery, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - F Heid
- Institute of Physiology, University of Zurich, Zurich, Switzerland.,Department of General and Visceral Surgery, Cantonal Hospital Winterthur, Winterthur, Switzerland
| | - W O Bechstein
- Department of General, Visceral and Transplant Surgery, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt, Germany
| | - M Bemelmans
- Department of Surgery, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - C Binkert
- Department of Radiology, Cantonal Hospital Winterthur, Winterthur, Switzerland
| | - B Björnsson
- Department of Surgery and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - S Breitenstein
- Department of General and Visceral Surgery, Cantonal Hospital Winterthur, Winterthur, Switzerland
| | - O Detry
- Department of Abdominal Surgery and Transplantation, University of Liege, Centre Hospitalier Universitaire de Liege, Liege, Belgium
| | - A Dili
- Department of Abdominal Surgery, Centre Hospitalier Universitaire Dinant Godinne Saint-Elisabeth - UCL-Namur, Yvoir, Belgium
| | - R F Dondelinger
- Department of Imaging, University Hospital Liege, Liege, Belgium
| | - L Gerard
- Department of Imaging, University Hospital Liege, Liege, Belgium
| | - T Giménez-Maurel
- Department of Surgery, Miguel University Hospital and University of Zaragoza, Zaragoza, Spain
| | - B Guiu
- Department of Radiology, St Eloi University Hospital, Montpellier, France
| | - D Heise
- Department of General, Visceral and Transplant Surgery, University Hospital Aachen, Aachen, Germany
| | - M Hertl
- Department of Surgery, Rush University Medical Center, Chicago, Illinois, USA
| | - J A Kalil
- Department of Surgery, Rush University Medical Center, Chicago, Illinois, USA
| | - J J Klein
- Department of Surgery, Rush University Medical Center, Chicago, Illinois, USA
| | - A Lakoma
- Department of Surgery, Section of Hepato-Pancreatico-Biliary Surgery, McGill University Health Center, Montreal, Quebec, Canada
| | - U P Neumann
- Department of General, Visceral and Transplant Surgery, University Hospital Aachen, Aachen, Germany
| | - B Olij
- Department of Surgery, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - S G Pappas
- Department of Surgery, Rush University Medical Center, Chicago, Illinois, USA
| | - P Sandström
- Department of Surgery and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - A Schnitzbauer
- Department of General, Visceral and Transplant Surgery, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt, Germany
| | - A Serrablo
- Department of Surgery, Miguel University Hospital and University of Zaragoza, Zaragoza, Spain
| | - J Tasse
- Department of Radiology, Rush University Medical Center, Chicago, USA
| | - C Van der Leij
- Department of Radiology, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - P Metrakos
- Department of Surgery, Section of Hepato-Pancreatico-Biliary Surgery, McGill University Health Center, Montreal, Quebec, Canada
| | - R Van Dam
- GROW - School for Oncology and Developmental Biology, Maastricht University, Maastricht, the Netherlands.,Department of Surgery, Maastricht University Medical Centre, Maastricht, the Netherlands.,Department of General, Visceral and Transplant Surgery, University Hospital Aachen, Aachen, Germany
| | - E Schadde
- Institute of Physiology, University of Zurich, Zurich, Switzerland.,Department of General and Visceral Surgery, Cantonal Hospital Winterthur, Winterthur, Switzerland.,Department of Surgery, Rush University Medical Center, Chicago, Illinois, USA
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12
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Heil J. Abstract SP058: Exceptional responders to neoadjuvant chemotherapy - Pro. Cancer Res 2021. [DOI: 10.1158/1538-7445.sabcs20-sp58] [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: 11/16/2022]
Abstract
Abstract
Increasing use of neoadjuvant systemic treatment (NST) and improved efficacy of treatment regimens have led to increasing numbers of patients without any detectable residual cancer upon surgery (pathologic complete response, pCR, ypT0, ypN0). For these exceptional responders to NST, invasive surgery may cause more harm than benefit and thus should be tailored to this response.
For nodal disease, axillary lymph node dissection (ALND) used to be the standard of care for all patients but ALND causes relevant morbidity (i.g. lymphedema, pain, restricted mobility). Sentinel lymph node biopsy (SLNB) causes less morbidity but its use for patients receiving NST has been controversial. Based on rates of missed cancer (false-negative rate, FNR) compared to ALND, several current national guidelines recommend use of SLNB for patients undergoing NST with initial nodal negative disease (FNR about 7%; Shirzadi et al 2019, J Res Med Sci) and use of targeted axillary dissection (TAD; removal of clipped nodes plus SLNB) for patients with initial nodal positive disease converting to nodal negative disease after NST (FNR about 2%; Caudle et al 2016, J Clin Onc). However, while already implemented in clinical practice recurrence and survival data are still lacking for SLNB/TAD after NST.
For the primary tumor in the breast, breast conserving surgery (BCS) is the current standard of care. The use of NST instead of adjuvant treatment has allowed for more patients to be treated with BCS instead of mastectomy with equal survival (EBCTCG 2018, Lancet Onc). Although BCS is a low morbidity procedure compared to other oncologic surgeries, also BCS causes morbidity relevant to patients: (1) About 30% of patients undergoing BCS and SLNB report moderate, persistent pain two years after surgery (Gärtner et al 2009, JAMA); (2) the reduction in patient-reported quality of life up to 8 years after surgery is comparable between patients undergoing BCS or mastectomy (Flanagan et al 2019, Ann Surg Onc). In the light of increasing ypT0 rates, current research evaluates alternative diagnostic procedures than BCS to identify these exceptional responders to NST who achieve ypT0. Imaging (ultrasound, mammography, MRI, PET-CT) is insufficiently accurate to reliably exclude residual disease (FNR about 20% for US and mammography) and/ or specificity is suboptimal (MRI, PET-CT) (Fowler et al 2017, Radiology). Vacuum-assisted biopsies (VAB) showed promising results in some pilot trials (FNR about 5%; Heil et al 2016, Eur J Cancer and Kuerer et al 2018, Ann Surg) which could however not be confirmed in larger multicenter trials (FNR about 18%; Heil, Pfob et al 2020, Ann Surg). Recent exploratory analyses using machine learning algorithms to combine VAB with patient and tumor data could decrease the FNR to ~3% while maintaining good specificity (Pfob et al 2020, ASCO meeting). However, we do not know yet to which extend these FNR would influence local recurrence or survival rates when omitting breast surgery for these exceptional responders to NST.
In summary, several less invasive and therefore less morbidity causing procedures are currently evaluated to identify exceptional responders to NST to spare them surgery-associated morbidity in the axilla and breast. TAD to identify ypN0 patients showed an FNR <2% in prospective trials and survival outcome analyses in these cohorts are underway. VAB combined with patient and tumor data to identify ypT0 patients showed promising results (FNR around 3%) in exploratory analyses but needs further prospective validation before trials with oncological endpoints should be considered. The topic is worth to be studied further to decrease potentially unnecessary treatment burden for patients, providers, and health care systems.
Citation Format: J Heil. Exceptional responders to neoadjuvant chemotherapy - Pro [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr SP058.
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Affiliation(s)
- J Heil
- Heidelberg University Hospital, Heidelberg, Germany
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13
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Hörner-Rieber J, Forster T, Hommertgen A, Haefner M, Arians N, König L, Harrabi S, Schlampp I, Lossner K, Weykamp F, Heinrich V, Weidner N, Hüsing J, Heil J, Hof H, Krug D, Debus J. First 2-Year Results of the Multicenter, Randomized IMRT-MC2 Trial (MINT): Intensity-Modulated Radiotherapy with Simultaneous Integrated Boost versus 3-D-Conformal Radiotherapy with Consecutive Boost for Breast Cancer Patients. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.2086] [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: 11/15/2022]
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14
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Schäfgen B, Juskic M, Heil J, Harcos A, Radicke M, Hertel M, Schütz F, Sohn C, Golatta M. First proof-of-concept evaluation of the FUSION-X-US-II prototype for the performance of automated breast ultrasound in healthy volunteers. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1717875] [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)
- B Schäfgen
- Universitätsfrauenklinik Heidelberg, Brustzentrum
| | - M Juskic
- Universitätsfrauenklinik Heidelberg, Brustzentrum
| | - J Heil
- Universitätsfrauenklinik Heidelberg, Brustzentrum
| | - A Harcos
- Universitätsfrauenklinik Heidelberg, Brustzentrum
| | | | | | - F Schütz
- Universitätsfrauenklinik Heidelberg, Brustzentrum
| | - C Sohn
- Universitätsfrauenklinik Heidelberg, Brustzentrum
| | - M Golatta
- Universitätsfrauenklinik Heidelberg, Brustzentrum
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15
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Paepke S, Kiechle M, Gerber-Schäfer C, Kümmel S, Faridi A, Bauer L, Thill M, Ankel C, Andrulat A, Gschwantler-Kaulich D, Heil J, Fink V, Ohlinger R. Präpektorale Implantateinlage in der plastisch-rekonstruktiven Mammachirurgie unter Verwendung des TiLOOP Bra Pocket – erste Daten der PRO-Pocket Studie. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1717892] [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)
- S Paepke
- Klinikum rechts der Isar,pechnische Universität München
| | - M Kiechle
- Klinikum rechts der Isar,pechnische Universität München
| | | | | | | | | | - M Thill
- Agaplesion Markus Krankenhaus
| | | | | | | | - J Heil
- Universitätsklinikum Heidelberg
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16
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Riedel F, Heil J, Feißt M, Moderow M, von Au A, Domschke C, Michel L, Schäfgen B, Golatta M, Hennigs A. Can the eligibility criteria of the ACOSOG Z0011 trial be extended to patients undergoing mastectomy and presenting T3-T4 tumors? An analysis of non-sentinel axillary metastases. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1717160] [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)
- F Riedel
- Universitätsklinikum Heidelberg, Universitäts-Frauenklinik Heidelberg
| | - J Heil
- Universitätsklinikum Heidelberg, Universitäts-Frauenklinik Heidelberg
| | - M Feißt
- Universitätsklinikum Heidelberg, Institut für Medizinische Biometrie und Informatik
| | | | - A von Au
- Universitätsklinikum Heidelberg, Universitäts-Frauenklinik Heidelberg
| | - C Domschke
- Universitätsklinikum Heidelberg, Universitäts-Frauenklinik Heidelberg
| | - L Michel
- Universitätsklinikum Heidelberg, Universitäts-Frauenklinik Heidelberg
| | - B Schäfgen
- Universitätsklinikum Heidelberg, Universitäts-Frauenklinik Heidelberg
| | - M Golatta
- Universitätsklinikum Heidelberg, Universitäts-Frauenklinik Heidelberg
| | - A Hennigs
- Universitätsklinikum Heidelberg, Universitäts-Frauenklinik Heidelberg
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17
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Pfob A, Sidey-Gibbons C, Tasoulis MK, Lee HB, Koelbel V, Kuerer HM, Heil J. Artificial intelligence to accurately identify and select breast cancer patients with a pathologic complete response for omission of surgery after neoadjuvant systemic therapy: an international multicenter analysis. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1717199] [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)
- A Pfob
- University Hospital Heidelberg, Department of Obstetrics and Gynecology
| | - C Sidey-Gibbons
- The University of Texas MD Anderson Cancer Center, Department of Symptom Research
| | | | - HB Lee
- Seoul National University College of Medicine, Department of Surgery
| | - V Koelbel
- University Hospital Heidelberg, Department of Obstetrics and Gynecology
| | - HM Kuerer
- The University of Texas MD Anderson Cancer Center, Department of Breast Surgical Oncology
| | - J Heil
- University Hospital Heidelberg, Department of Obstetrics and Gynecology
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18
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Riedel M, Hennigs A, Dobberkau AM, Deutsch T, Rippinger N, Wallwiener M, Finkenzeller C, Golatta M, Heil J, Riedel F. Evaluation genderspezifischer Faktoren und Assoziationen für die Wahl zur Facharztweiterbildung in der Gynäkologie und Geburtshilfe – Ergebnisse einer Befragung unter Medizinstudierenden im klinischen Studienabschnitt. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1718105] [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)
- M Riedel
- Klinikum rechts der Isar der Technischen Universität München, Frauenklinik
| | - A Hennigs
- Universitätsklinikum Heidelberg, Universitäts-Frauenklinik Heidelberg
| | - A.-M Dobberkau
- Universitätsklinikum Heidelberg, Universitäts-Frauenklinik Heidelberg
| | - T Deutsch
- Universitätsklinikum Heidelberg, Universitäts-Frauenklinik Heidelberg
| | - N Rippinger
- Universitätsklinikum Heidelberg, Universitäts-Frauenklinik Heidelberg
| | - M Wallwiener
- Universitätsklinikum Heidelberg, Universitäts-Frauenklinik Heidelberg
| | - C Finkenzeller
- Universitätsklinikum Heidelberg, Klinik für Allgemeine Innere Medizin und Psychosomatik
| | - M Golatta
- Universitätsklinikum Heidelberg, Universitäts-Frauenklinik Heidelberg
| | - J Heil
- Universitätsklinikum Heidelberg, Universitäts-Frauenklinik Heidelberg
| | - F Riedel
- Universitätsklinikum Heidelberg, Universitäts-Frauenklinik Heidelberg
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Riedel F, Hoffmann AS, Moderow M, Heublein S, Deutsch T, Golatta M, Wallwiener M, Schneeweiss A, Heil J, Hennigs A. Wie hat sich die Anwendung von adjuvanter zu neoadjuvanter Chemotherapie beim frühen Mammakarzinom verändert? – Daten von 104 deutschen Brustzentren 2008-2017. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1717872] [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)
- F Riedel
- Universitätsklinikum Heidelberg, Universitäts-Frauenklinik Heidelberg
| | - AS Hoffmann
- Universitätsklinikum Heidelberg, Universitäts-Frauenklinik Heidelberg
| | | | - S Heublein
- Universitätsklinikum Heidelberg, Universitäts-Frauenklinik Heidelberg
| | - T Deutsch
- Universitätsklinikum Heidelberg, Universitäts-Frauenklinik Heidelberg
| | - M Golatta
- Universitätsklinikum Heidelberg, Universitäts-Frauenklinik Heidelberg
| | - M Wallwiener
- Universitätsklinikum Heidelberg, Universitäts-Frauenklinik Heidelberg
| | - A Schneeweiss
- Universitätsklinikum Heidelberg, Universitäts-Frauenklinik Heidelberg
- Nationales Centrum für Tumorerkrankungen
- Deutsches Krebsforschungszentrum
| | - J Heil
- Universitätsklinikum Heidelberg, Universitäts-Frauenklinik Heidelberg
| | - A Hennigs
- Universitätsklinikum Heidelberg, Universitäts-Frauenklinik Heidelberg
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Schäfgen B, Riedel F, Sinn P, Feisst M, Hennigs A, Hug S, Binning A, Sohn C, Golatta M, Gläser A, Heil J. Diagnostic accuracy and clinical utility of axillary ultrasound in the evaluation of axillary lymph node status in early breast cancer patients. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1717874] [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)
| | | | | | - M Feisst
- Institute of Medical Biometry and Informatics
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Gerber B, Schneeweiss A, Möbus V, Golatta M, Tesch H, Krug D, Denkert C, Lübbe K, Heil J, Ataseven B, Klare P, Untch M, Kast K, Jackisch C, Seither F, Nekljudova V, Loibl S, Kühn T. Management of the axilla for high-risk early breast cancer (EBC) before and after neoadjuvant chemotherapy (NACT): an analysis of the multicentre GeparOcto trial. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1714551] [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: 03/22/2023] Open
Affiliation(s)
- B Gerber
- Department of Obstetrics and Gynaecology, University of Rostock
| | | | | | | | - H Tesch
- Bethanien Krankenhaus Frankfurt
| | - D Krug
- Universitätsklinikum Schleswig-Holstein Kiel, Klinik für Strahlentherapie
| | - C Denkert
- Universitätsklinikum Marburg, Institut für Pathologie UKGM
| | - K Lübbe
- Diakovere Henriettenstiftung Hannover
| | - J Heil
- Universitätsklinikum Heidelberg
| | | | - P Klare
- Praxisklinik Krebsheilkunde für Frauen
| | | | - K Kast
- Universitätsklinikum Carl Gustav Carus Dresden
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Heil J, Pfob A. Patients should be the tipping point of individualizing breast cancer surgery: Commentary on 'Eliminating the breast cancer surgery paradigm after neoadjuvant systemic therapy: current evidence and future challenges'. Ann Oncol 2020; 31:1264. [PMID: 32473970 DOI: 10.1016/j.annonc.2020.05.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 05/10/2020] [Indexed: 10/24/2022] Open
Affiliation(s)
- J Heil
- Department of Gynecology, Heidelberg University, Heidelberg, Germany.
| | - A Pfob
- Department of Gynecology, Heidelberg University, Heidelberg, Germany
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Weber W, Henke G, Ribi K, Hayoz S, Seiler S, Maddox C, Ruhstaller T, Zwahlen D, Muenst S, Ackerknecht M, Fitzal F, Matrai Z, Újhelyi M, Kurzeder C, Lelièvre L, Tausch C, Heil J, Knauer M. 126TiP Tailored axillary surgery with or without axillary lymph node dissection followed by radiotherapy in patients with clinically node-positive breast cancer (SAKK 23/16 / IBCSG 57-18 / ABCSG-53 / GBG 101 - TAXIS): A multicenter randomized phase III trial. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.03.229] [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: 11/26/2022] Open
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Reinisch M, Heil J, Rüland A, Seiberling C, Harrach H, Schindowski D, Lubitz J, Ankel C, Graßhoff ST, Deuschle P, Hanf V, Holtschmidt J, Traut E, Kuehn T, Kuemmel S. Prospective, multicenter registry trial to evaluate the clinical feasibility of targeted axillary dissection (TAD) in patients (pts) with breast cancer (BC) and core biopsy proven axillary involvement (cN+). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz240.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Caballero C, Alvarez LC, Nilsson H, Ruers T, Senellart P, Rivoire M, Staettner S, Primavesi F, Troisi R, Gruenberger T, Heil J, Schnitzbauer A, Rahbari N, Swijnenburg R, Malik H, Protic M, Neven A, Mauer M, Poston G, Evrard S. EORTC 1409 GITCG / ESSO 01 - A prospective colorectal liver metastasis database with an integrated quality assurance program (CLIMB): Primary analysis of variations in European clinical practices and surgical complications after complex liver metastasis surgeries. Eur J Surg Oncol 2019. [DOI: 10.1016/j.ejso.2018.10.093] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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26
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Riedel F, Heil J, Golatta M, Schaefgen B, Hug S, Schott S, Rom J, Schuetz F, Sohn C, Hennigs A. Changes of breast and axillary surgery patterns in patients with primary breast cancer during the past decade. Arch Gynecol Obstet 2018; 299:1043-1053. [PMID: 30478667 DOI: 10.1007/s00404-018-4982-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Accepted: 11/16/2018] [Indexed: 12/17/2022]
Abstract
PURPOSE Breast-conserving therapy (BCT) is the standard procedure for most patients with primary breast cancer (BC). By contrast, axillary management is still under transition to find the right balance between avoiding of morbidity, maintaining oncological safety, and performing a staging procedure. The rising rate of primary systemic therapy creates further challenges for surgical management. METHODS Patients with primary, non-metastatic BC treated between 01.01.2003 and 31.12.2016 under guideline-adherent conditions were included in this study. For this prospectively followed cohort, breast and axillary surgery patterns are presented in a time-trend analysis as annual rate data (%) for several subgroups. RESULTS Overall, 6700 patients were included in the analysis. While BCT rates remained high (mean 2003-2016: 70.4%), the proportion of axillary lymph node dissection has declined considerably from 80.1% in 2003 to 16.0% in 2016, while the proportion for sentinel lymph node biopsy (SLND) has increased correspondingly from 10.3 to 76.4%. Among patients with cT1-2, cN0 breast cancer receiving BCT with positive SLND, the rate of axillary completion has decreased from 100% in 2008 to 24.4% in 2016. CONCLUSIONS In the past decade, SLNB has been established as the standard procedure for axillary staging of clinically node-negative patients. Surgical morbidity has been further reduced by the rapid implementation of new evidence from the ACOSOG Z0011 trial into clinical routine. The results reflect the transition towards more individually tailored, less invasive treatment for selected patient subgroups, especially in regards to axillary lymph node management.
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Affiliation(s)
- F Riedel
- Department of Gynecology and Obstetrics, Heidelberg University Hospital, Im Neuenheimer Feld 440, 69120, Heidelberg, Germany
| | - J Heil
- Department of Gynecology and Obstetrics, Heidelberg University Hospital, Im Neuenheimer Feld 440, 69120, Heidelberg, Germany
| | - M Golatta
- Department of Gynecology and Obstetrics, Heidelberg University Hospital, Im Neuenheimer Feld 440, 69120, Heidelberg, Germany
| | - B Schaefgen
- Department of Gynecology and Obstetrics, Heidelberg University Hospital, Im Neuenheimer Feld 440, 69120, Heidelberg, Germany
| | - S Hug
- Department of Gynecology and Obstetrics, Heidelberg University Hospital, Im Neuenheimer Feld 440, 69120, Heidelberg, Germany
| | - S Schott
- Department of Gynecology and Obstetrics, Heidelberg University Hospital, Im Neuenheimer Feld 440, 69120, Heidelberg, Germany
| | - J Rom
- Department of Gynecology and Obstetrics, Heidelberg University Hospital, Im Neuenheimer Feld 440, 69120, Heidelberg, Germany
| | - F Schuetz
- Department of Gynecology and Obstetrics, Heidelberg University Hospital, Im Neuenheimer Feld 440, 69120, Heidelberg, Germany
| | - C Sohn
- Department of Gynecology and Obstetrics, Heidelberg University Hospital, Im Neuenheimer Feld 440, 69120, Heidelberg, Germany
| | - A Hennigs
- Department of Gynecology and Obstetrics, Heidelberg University Hospital, Im Neuenheimer Feld 440, 69120, Heidelberg, Germany.
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Riedel F, Heil J, Mahdi R, Nitz U, Moderow M, Golatta M, Schäfgen B, Sohn C, Schütz F, Schneeweiss A, Hennigs A. Chemotherapie-Anwendung beim frühen Mammakarzinom in Deutschland – aktuelle Daten aus 179 Brustkrebszentren (2008 – 2015). Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671630] [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)
- F Riedel
- Universitätsklinikum Heidelberg, Frauenklinik, Heidelberg, Deutschland
| | - J Heil
- Universitätsklinikum Heidelberg, Frauenklinik, Heidelberg, Deutschland
| | - R Mahdi
- Europäisches Brustzentrum Dr. Mahdi Rezai, Luisenkrankenhaus, Düsseldorf, Deutschland
| | - U Nitz
- Evangelisches Krankenhaus Bethesda, Brustzentrum Niederrhein, Mönchengladbach, Deutschland
| | - M Moderow
- Westdeutsches Brust-Centrum GmbH, Düsseldorf, Deutschland
| | - M Golatta
- Universitätsklinikum Heidelberg, Frauenklinik, Heidelberg, Deutschland
| | - B Schäfgen
- Universitätsklinikum Heidelberg, Frauenklinik, Heidelberg, Deutschland
| | - C Sohn
- Universitätsklinikum Heidelberg, Frauenklinik, Heidelberg, Deutschland
| | - F Schütz
- Universitätsklinikum Heidelberg, Frauenklinik, Heidelberg, Deutschland
| | - A Schneeweiss
- Universitätsklinikum Heidelberg, Frauenklinik, Heidelberg, Deutschland
- Nationales Centrum für Tumorerkrankungen, Heidelberg, Deutschland
| | - A Hennigs
- Universitätsklinikum Heidelberg, Frauenklinik, Heidelberg, Deutschland
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Köpke M, Feißt M, Rezai M, Nitz U, Moderow M, Riedel F, Golatta M, Sohn C, Schneeweiss A, Heil J, Hennigs A. Veränderung des axillären Managements bei Brustkrebspatientinnen mit 1 – 2 tumorbefallenen Sentinel-Lymphknoten. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671221] [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)
- M Köpke
- Universitätsfrauenklinik Heidelberg, Heidelberg, Deutschland
| | - M Feißt
- Medizinische Biometrie und Informatik, Heidelberg, Deutschland
| | - M Rezai
- Europäisches Brustzentrum Dr. Mahdi Rezai, Luisenkrankenhaus, Düsseldorf, Deutschland
| | - U Nitz
- Evangelisches Krankenhaus Bethesda, Brustzentrum Niederrhein, Mönchengladbach, Deutschland
| | - M Moderow
- Westdeutsches Brust-Centrum GmbH, Düsseldorf, Deutschland
| | - F Riedel
- Universitätsfrauenklinik Heidelberg, Heidelberg, Deutschland
| | - M Golatta
- Universitätsfrauenklinik Heidelberg, Heidelberg, Deutschland
| | - C Sohn
- Universitätsfrauenklinik Heidelberg, Heidelberg, Deutschland
| | - A Schneeweiss
- Nationales Centrum für Tumorerkrankungen, Heidelberg, Deutschland
| | - J Heil
- Universitätsfrauenklinik Heidelberg, Heidelberg, Deutschland
| | - A Hennigs
- Universitätsfrauenklinik Heidelberg, Heidelberg, Deutschland
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29
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Heublein S, Burgert S, Marme F, Schütz F, Heil J, Jäger D, Braun E, Ladra C, Lange C, Sohn C, Sinn P, Schneeweiss A. Der Einfluss des Patientinnenalters auf Therapie und Prognose des Mammakarzinoms. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671223] [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 Heublein
- Universitäts-Frauenklinik Heidelberg, Heidelberg, Deutschland
| | - S Burgert
- Universitäts-Frauenklinik Heidelberg, Heidelberg, Deutschland
| | - F Marme
- Universitäts-Frauenklinik Heidelberg, Heidelberg, Deutschland
| | - F Schütz
- Universitäts-Frauenklinik Heidelberg, Heidelberg, Deutschland
| | - J Heil
- Universitäts-Frauenklinik Heidelberg, Heidelberg, Deutschland
| | - D Jäger
- Nationales Centrum für Tumorerkrankungen Heidelberg, Heidelberg, Deutschland
| | - E Braun
- Universitäts-Frauenklinik Heidelberg, Heidelberg, Deutschland
| | - C Ladra
- Universitäts-Frauenklinik Heidelberg, Heidelberg, Deutschland
| | - C Lange
- Nationales Centrum für Tumorerkrankungen Heidelberg, Heidelberg, Deutschland
| | - C Sohn
- Universitäts-Frauenklinik Heidelberg, Heidelberg, Deutschland
| | - P Sinn
- Pathologisches Institut der Universität Heidelberg, Heidelberg, Deutschland
| | - A Schneeweiss
- Universitäts-Frauenklinik Heidelberg, Heidelberg, Deutschland
- Nationales Centrum für Tumorerkrankungen Heidelberg, Heidelberg, Deutschland
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Funk A, Schäfgen B, Heil J, Harcos A, Gomez C, Stieber A, Junkermann H, Hennigs A, Rauch G, Sinn HP, Riedel F, Hug S, Meier A, Schott S, Rom J, Schütz F, Sohn C, Golatta M. Evaluation des Nutzens von intraoperativer Präparateradiografie zur Randbeurteilung bei brusterhaltender Therapie maligner Brusttumore. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671333] [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)
- A Funk
- Universitätsfrauenklinik Heidelberg, Heidelberg, Deutschland
| | - B Schäfgen
- Universitätsfrauenklinik Heidelberg, Heidelberg, Deutschland
| | - J Heil
- Universitätsfrauenklinik Heidelberg, Heidelberg, Deutschland
| | - A Harcos
- Universitätsfrauenklinik Heidelberg, Heidelberg, Deutschland
| | - C Gomez
- Universitätsfrauenklinik Heidelberg, Heidelberg, Deutschland
| | - A Stieber
- Universitätsfrauenklinik Heidelberg, Heidelberg, Deutschland
| | - H Junkermann
- Universitätsfrauenklinik Heidelberg, Heidelberg, Deutschland
| | - A Hennigs
- Universitätsfrauenklinik Heidelberg, Heidelberg, Deutschland
| | - G Rauch
- Institut für Medizinische Biometrie und Informatik, Heidelberg, Deutschland
| | - HP Sinn
- Institut für Pathologie und Neuropathologie, Heidelberg, Deutschland
| | - F Riedel
- Universitätsfrauenklinik Heidelberg, Heidelberg, Deutschland
| | - S Hug
- Universitätsfrauenklinik Heidelberg, Heidelberg, Deutschland
| | - A Meier
- Universitätsfrauenklinik Heidelberg, Heidelberg, Deutschland
| | - S Schott
- Universitätsfrauenklinik Heidelberg, Heidelberg, Deutschland
| | - J Rom
- Universitätsfrauenklinik Heidelberg, Heidelberg, Deutschland
| | - F Schütz
- Universitätsfrauenklinik Heidelberg, Heidelberg, Deutschland
| | - C Sohn
- Universitätsfrauenklinik Heidelberg, Heidelberg, Deutschland
| | - M Golatta
- Universitätsfrauenklinik Heidelberg, Heidelberg, Deutschland
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Schaefgen B, Heil J, Barr R, Radicke M, Harcos A, Gomez A, Stieber A, Andre H, Von Au A, Spratte J, Rauch G, Rom J, Schütz F, Sohn C, Golatta M. Initial results of the FUSION-X-US prototype combining 3D automated breast ultrasound and tomosynthesis. Eur J Cancer 2018. [DOI: 10.1016/s0959-8049(18)30694-4] [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: 11/26/2022]
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van Dam P, Tomatis M, Marotti L, Heil J, Mansel R, Rosselli del Turco M, van Dam P, Casella D, Bassani L, Danei M, Denk A, Egle D, Emons G, Friedrichs K, Harbeck N, Kiechle M, Kimmig R, Koehler U, Kuemmel S, Maass N, Mayr C, Prové A, Rageth C, Regolo L, Lorenz-Salehi F, Sarlos D, Singer C, Sohn C, Staelens G, Tinterri C, Audisio R, Ponti A, Badbanchi F, Catalano G, Cretella E, Daniaux M, Emons A, van Eygen K, Ettl J, Gatzemeier W, Kern P, Schneeweiss A, Stoeblen F, Van As A, Wuerstlein R, Zanini V. Time trends (2006–2015) of quality indicators in EUSOMA-certified breast centres. Eur J Cancer 2017; 85:15-22. [DOI: 10.1016/j.ejca.2017.07.040] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Revised: 05/31/2017] [Accepted: 07/25/2017] [Indexed: 12/21/2022]
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Riedel F, Schneeweiss A, Sinn HP, Marmé F, Golatta M, Wallwiener M, Schütz F, Sohn C, Heil J, Hennigs A. Veränderungen in der Anwendung und beim Outcome von Chemotherapie beim frühen Mammakarzinom in der letzten Dekade. Geburtshilfe Frauenheilkd 2017. [DOI: 10.1055/s-0037-1606152] [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] Open
Affiliation(s)
- F Riedel
- Universitätsklinikum Heidelberg, Frauenklinik, Heidelberg
| | - A Schneeweiss
- Universitätsklinikum Heidelberg, Frauenklinik, Heidelberg
- Nationales Centrum für Tumorerkrankungen (NCT), Heidelberg
| | - HP Sinn
- Universitätsklinikum Heidelberg, Pathologisches Institut, Heidelberg
| | - F Marmé
- Universitätsklinikum Heidelberg, Frauenklinik, Heidelberg
| | - M Golatta
- Universitätsklinikum Heidelberg, Frauenklinik, Heidelberg
| | - M Wallwiener
- Universitätsklinikum Heidelberg, Frauenklinik, Heidelberg
| | - F Schütz
- Universitätsklinikum Heidelberg, Frauenklinik, Heidelberg
| | - C Sohn
- Universitätsklinikum Heidelberg, Frauenklinik, Heidelberg
| | - J Heil
- Universitätsklinikum Heidelberg, Frauenklinik, Heidelberg
| | - A Hennigs
- Universitätsklinikum Heidelberg, Frauenklinik, Heidelberg
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Schwentner L, Helms G, Nekljudova V, Ataseven B, Bauerfeind I, Ditsch N, Fehm T, Fleige B, Hauschild M, Heil J, Kümmel S, Lebeau A, Schmatloch S, Schrenk P, Staebler A, Loibl S, Untch M, Von Minckwitz G, Liedtke C, Kühn T. Using ultrasound and palpation for predicting axillary lymph node status following neoadjuvant chemotherapy – Results from the multi-center SENTINA trial. Breast 2017; 31:202-207. [DOI: 10.1016/j.breast.2016.11.012] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2016] [Revised: 11/10/2016] [Accepted: 11/11/2016] [Indexed: 10/20/2022] Open
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Hennigs A, Riedel F, Marmé F, Sinn P, Lindel K, Gondos A, Smetanay K, Golatta M, Sohn C, Schuetz F, Heil J, Schneeweiss A. Changes in chemotherapy usage and outcome of early breast cancer patients in the last decade. Breast Cancer Res Treat 2016; 160:491-499. [PMID: 27744486 PMCID: PMC5090013 DOI: 10.1007/s10549-016-4016-4] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Accepted: 10/08/2016] [Indexed: 11/23/2022]
Abstract
Background During the last decade, neoadjuvant chemotherapy (NACT) of early breast cancer (EBC) evolved from a therapy intended to enable operability to a standard treatment option aiming for increasing cure rates equivalent to adjuvant chemotherapy (ACT). In parallel, improvements in the quality control of breast cancer care have been established in specialized breast care units. Patients and methods This study analyzed chemotherapy usage in patients with EBC treated at the Heidelberg University Breast Unit between January 2003 and December 2014. Results Overall, 5703 patients were included in the analysis of whom 2222 (39 %) received chemotherapy, 817 (37 %) as NACT, and 1405 (63 %) as ACT. The chemotherapy usage declined from 48 % in 2003 to 34 % in 2014 of the cohort. Further, the proportion of NACT raised from 42 to 65 % irrespective of tumor subtype. In addition, frequency of pathologic complete response (pCR) defined as no tumor residues in breast and axilla (ypT0 ypN0) at surgery following NACT increased from 12 % in 2003 to 35 % in 2014. The greatest effect was observed in HER2+ breast cancer with an increase in patients achieving pCR from 24 to 68 %. Conclusions The results mirror the refined indication for chemotherapy in EBC and its preferred usage as NACT in Germany. The increase in pCR rate over time suggests improvement in outcome accomplished by a multidisciplinary decision-making process and stringent measures for quality control. Electronic supplementary material The online version of this article (doi:10.1007/s10549-016-4016-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- A Hennigs
- Department of Gynecology and Obstetrics, University of Heidelberg, Heidelberg, Germany
| | - F Riedel
- Department of Gynecology and Obstetrics, University of Heidelberg, Heidelberg, Germany
| | - F Marmé
- Department of Gynecology and Obstetrics, University of Heidelberg, Heidelberg, Germany.,National Center for Tumor Diseases (NCT), University of Heidelberg, Heidelberg, Germany
| | - P Sinn
- Department of Pathology, University of Heidelberg, Heidelberg, Germany
| | - K Lindel
- Department of Radiation Oncology, University of Heidelberg, Heidelberg, Germany
| | - A Gondos
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - K Smetanay
- Department of Gynecology and Obstetrics, University of Heidelberg, Heidelberg, Germany
| | - M Golatta
- Department of Gynecology and Obstetrics, University of Heidelberg, Heidelberg, Germany
| | - C Sohn
- Department of Gynecology and Obstetrics, University of Heidelberg, Heidelberg, Germany
| | - F Schuetz
- Department of Gynecology and Obstetrics, University of Heidelberg, Heidelberg, Germany
| | - J Heil
- Department of Gynecology and Obstetrics, University of Heidelberg, Heidelberg, Germany
| | - A Schneeweiss
- Department of Gynecology and Obstetrics, University of Heidelberg, Heidelberg, Germany. .,National Center for Tumor Diseases (NCT), University of Heidelberg, Heidelberg, Germany.
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Heil J, Schaefgen B, Sinn P, Richter H, Harcos A, Gomez C, Stieber A, Hennigs A, Rauch G, Schneeweiss A, Schuetz F, Sohn C, Golatta M. Kann eine pathologische Komplettremission nach neoadjuvanter Chemotherapie bei Brustkrebspatientinnen mithilfe einer minimal invasiven Biopsie diagnostiziert werden? Ergebnisse einer prospektiven Pilotstudie. Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1592805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Hennigs A, Riedel F, Gondos A, Sinn HP, Marmé F, Golatta M, Rom J, Schütz F, Sohn C, Heil J, Schneeweiss A. Ergebnisqualität von Brustkrebs-Subtypen in der klinischen Routine – eine große, prospektive Kohortenstudie. Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1593144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Riedel F, Fremd C, Tabatabai P, Smetanay K, Doster A, Golatta M, Heil J, Schütz F, Sohn C, Hennigs A. Examensvorbereitungskurs für die Zweite Ärztliche Prüfung im Fach Gynäkologie und Geburtshilfe – Ein Proof-of-Concept an der Universitätsfrauenklinik Heidelberg. Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1593051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Michel L, Sommer L, González Silos R, Lorenzo Bermejo J, Hennigs A, Golatta M, Heil J, Schneeweiss A, Sohn C, Marmé F. Evaluation des MD Anderson Prognostic Index (MDAPI) zur lokoregionären Risikostratifikation in der neoadjuvanten Therapiesituation. Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1592811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Vetter L, Keller M, Bruckner T, Dikow N, Golatta M, Sohn C, Heil J, Schott S. Intensiviertes Früherkennungs- und Nachsorgeprogramm oder prophylaktische Operation? Entscheidungen von Frauen aus Familien mit familiärem Brust- und Eierstockkrebs. Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1592969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Hennigs A, Heil J, Gondos A, Riedel F, Marme F, Sinn HP, Schirmacher P, Kauczor HU, Debus J, Golatta M, Schtz F, Sohn C, Schneeweiss A. Abstract P1-07-12: Prognosis of clinico-pathological breast cancer subtypes in routine clinical care. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-p1-07-12] [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: 11/16/2022]
Abstract
Abstract
Background / Aim: To analyze oncological outcome of breast cancer (BC) subtypes in routine clinical care in specialized breast care units (BCU).
Patients and methods: A prospectively followed cohort of 4110 female cases with primary, non-bilateral, non-metastatic BC treated between 01.01.2003 and 31.12.2012 has been analyzed for the whole cohort and separately for the five routinely used clinico-pathological subtypes (i.e. Luminal A, Luminal B (=Her2 neg.), Luminal B (=Her2 pos.), HER-2, triple negative). The median follow-up of the cohort was 51 month. We calculated estimates for local control rate (LCR), disease-free survival (DFS), distant disease-free survival (DDFS), overall survival (OS) and relative overall survival (ROS).
5 year outcome results referred to 5 different endpoints (using Kaplan-Meier method) of all patients with primary, non-metastatic, non-bilateral breast cancer treated at Heidelberg Breast Care Unit between 01.01.2003 and 31.12.2012 All patients (including in-situ)Patients with invasive cancer (excluding in-situ) n=4102 (including 499 in-situ cases)n = 3603LCR [%] (95% CI)96.1 (95.6 ; 96.6)96.1 (95.7 ; 96.5)DFS [%] (95% CI)85.0 (84.2 ; 85.8)83.7 (82.8 ; 84.6)DDFS [%] (95% CI)86.9 (86.1 ; 87.7)85.7 (84.8 ; (86.6)OS [%] (95% CI)91.3 (90.5 ; 92.2)90.5 (89.6 ; 91.4)ROS [%] (95% CI)95.5 (94.3 ; 96.7)94.7 (93.4 ; 96.0)CI, confidence interval; LCR, local recurrence rate; DFS, disease-free survival; DDFS, distant disease-free survival; OS, observed overall survival; ROS, relative (age adjusted) overall survival
Outcome results referred to 5 different endpoints (using Kaplan-Meier method) according to clinico-pathological tumor subtype or in-situ tumor. Results in percent at 5 years (95% CI).invasive cancer (n = 34541) Lum A-likeLum B1-likeLum B2-likeHER2+Triple negativeCIS (n = 499)LCR [%] (95% CI)99.1 (98.7 ; 99.5)95.2 (-)**95.0 (86.3 ; 100)90.5 (-)89.6 (87.1 ; 92.1)96.2 (94.3 ; 98.1)DFS [%] (95% CI)92.2 (90.9 ; 93.5)80.1 (78.6 ; 81.6)79.0 (71.0 ; 86.0)77.0 (-)69.1 (66.4 ; 71.8)93.0 (91.3 ; 94.7)DDFS [%] (95% CI)92.9 (91.6 ; 94.2)82.2 (80.5 ; 83.9)82.8 (76.5 ; 89.1)83.3 (-)72.2 (70.7 ; 73.7)95.6 (94.4 ; 96.8)OS [%] (95% CI)95.1 (94.1 ; 96.1)88.7 (86.6 ; 90.8)92.5 (87.5 ; 97.5)85.6 (79.9 ; 91.3)78.5 (76.4 ; 80.6)96.9 (95.2 ; 98.6)ROS [%] (95% CI)100.0 (98.5 ; 100)93.4 (90.7 ; 96.1)96.0 (91.2 ; 100)88.8 (81.4 ; 96.2)80.1 (75.1 ; 85.1)100.0 (97.8 ; 100)
Results: LCR, DFS, DDFS, OS and ROS over 5 years for the whole cohort of invasive cases were 96.1%, 83.7%, 85.7%, 90.5% and 94.7%, respectively. Luminal A tumors were the most frequent (44.7%) and showed the best outcome with LCR, OS and ROS over 5 years at 99.1%, 95.1% and 100.0%, respectively; while triple negative tumors presented the poorest outcome with LCR, OS and ROS over 5 years at 89.6%, 78.5% and 80.1%, respectively.
Conclusions: This outcome analysis of a large cohort of patients with primary BC diagnosed, treated and prospectively followed on a routine basis at a specialized BCU in Germany confirmed general and detailed clinico-pathological subtype outcome data of clinical trials.
Citation Format: Hennigs A, Heil J, Gondos A, Riedel F, Marme F, Sinn H-P, Schirmacher P, Kauczor H-U, Debus J, Golatta M, Schtz F, Sohn C, Schneeweiss A. Prognosis of clinico-pathological breast cancer subtypes in routine clinical care. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P1-07-12.
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Affiliation(s)
- A Hennigs
- Department of Obstetrics and Gynecology, University of Heidelberg, Heidelberg, Germany; Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany; Department of Pathology, University of Heidelberg, Heidelberg; Department of Radiology, University of Heidelberg, Heidelberg, Germany; Department of Radio-Oncology, University of Heidelberg, Heidelberg, Germany; National Center for Tumor Diseases, University of Heidelberg, Heidelberg, Germany
| | - J Heil
- Department of Obstetrics and Gynecology, University of Heidelberg, Heidelberg, Germany; Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany; Department of Pathology, University of Heidelberg, Heidelberg; Department of Radiology, University of Heidelberg, Heidelberg, Germany; Department of Radio-Oncology, University of Heidelberg, Heidelberg, Germany; National Center for Tumor Diseases, University of Heidelberg, Heidelberg, Germany
| | - A Gondos
- Department of Obstetrics and Gynecology, University of Heidelberg, Heidelberg, Germany; Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany; Department of Pathology, University of Heidelberg, Heidelberg; Department of Radiology, University of Heidelberg, Heidelberg, Germany; Department of Radio-Oncology, University of Heidelberg, Heidelberg, Germany; National Center for Tumor Diseases, University of Heidelberg, Heidelberg, Germany
| | - F Riedel
- Department of Obstetrics and Gynecology, University of Heidelberg, Heidelberg, Germany; Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany; Department of Pathology, University of Heidelberg, Heidelberg; Department of Radiology, University of Heidelberg, Heidelberg, Germany; Department of Radio-Oncology, University of Heidelberg, Heidelberg, Germany; National Center for Tumor Diseases, University of Heidelberg, Heidelberg, Germany
| | - F Marme
- Department of Obstetrics and Gynecology, University of Heidelberg, Heidelberg, Germany; Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany; Department of Pathology, University of Heidelberg, Heidelberg; Department of Radiology, University of Heidelberg, Heidelberg, Germany; Department of Radio-Oncology, University of Heidelberg, Heidelberg, Germany; National Center for Tumor Diseases, University of Heidelberg, Heidelberg, Germany
| | - H-P Sinn
- Department of Obstetrics and Gynecology, University of Heidelberg, Heidelberg, Germany; Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany; Department of Pathology, University of Heidelberg, Heidelberg; Department of Radiology, University of Heidelberg, Heidelberg, Germany; Department of Radio-Oncology, University of Heidelberg, Heidelberg, Germany; National Center for Tumor Diseases, University of Heidelberg, Heidelberg, Germany
| | - P Schirmacher
- Department of Obstetrics and Gynecology, University of Heidelberg, Heidelberg, Germany; Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany; Department of Pathology, University of Heidelberg, Heidelberg; Department of Radiology, University of Heidelberg, Heidelberg, Germany; Department of Radio-Oncology, University of Heidelberg, Heidelberg, Germany; National Center for Tumor Diseases, University of Heidelberg, Heidelberg, Germany
| | - H-U Kauczor
- Department of Obstetrics and Gynecology, University of Heidelberg, Heidelberg, Germany; Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany; Department of Pathology, University of Heidelberg, Heidelberg; Department of Radiology, University of Heidelberg, Heidelberg, Germany; Department of Radio-Oncology, University of Heidelberg, Heidelberg, Germany; National Center for Tumor Diseases, University of Heidelberg, Heidelberg, Germany
| | - J Debus
- Department of Obstetrics and Gynecology, University of Heidelberg, Heidelberg, Germany; Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany; Department of Pathology, University of Heidelberg, Heidelberg; Department of Radiology, University of Heidelberg, Heidelberg, Germany; Department of Radio-Oncology, University of Heidelberg, Heidelberg, Germany; National Center for Tumor Diseases, University of Heidelberg, Heidelberg, Germany
| | - M Golatta
- Department of Obstetrics and Gynecology, University of Heidelberg, Heidelberg, Germany; Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany; Department of Pathology, University of Heidelberg, Heidelberg; Department of Radiology, University of Heidelberg, Heidelberg, Germany; Department of Radio-Oncology, University of Heidelberg, Heidelberg, Germany; National Center for Tumor Diseases, University of Heidelberg, Heidelberg, Germany
| | - F Schtz
- Department of Obstetrics and Gynecology, University of Heidelberg, Heidelberg, Germany; Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany; Department of Pathology, University of Heidelberg, Heidelberg; Department of Radiology, University of Heidelberg, Heidelberg, Germany; Department of Radio-Oncology, University of Heidelberg, Heidelberg, Germany; National Center for Tumor Diseases, University of Heidelberg, Heidelberg, Germany
| | - C Sohn
- Department of Obstetrics and Gynecology, University of Heidelberg, Heidelberg, Germany; Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany; Department of Pathology, University of Heidelberg, Heidelberg; Department of Radiology, University of Heidelberg, Heidelberg, Germany; Department of Radio-Oncology, University of Heidelberg, Heidelberg, Germany; National Center for Tumor Diseases, University of Heidelberg, Heidelberg, Germany
| | - A Schneeweiss
- Department of Obstetrics and Gynecology, University of Heidelberg, Heidelberg, Germany; Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany; Department of Pathology, University of Heidelberg, Heidelberg; Department of Radiology, University of Heidelberg, Heidelberg, Germany; Department of Radio-Oncology, University of Heidelberg, Heidelberg, Germany; National Center for Tumor Diseases, University of Heidelberg, Heidelberg, Germany
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Hennigs A, Heil J. Abstract P5-02-01: Diagnosis of pathological complete response by vacuum-assisted minimal invasive biopsy after neoadjuvant chemotherapy in breast cancer - Results from a prospective pilot study. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-p5-02-01] [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: 11/16/2022]
Abstract
Abstract
Purpose:
To explore the ability of vacuum-assisted-biopsy (VAB) to diagnose pathological complete response (pCR) or residual tumor in breast cancer patients after neoadjuvant chemotherapy (NACT).
Patients and methods: 50 patients (22 with clinical / imaging complete response 28 with clinical / imaging residual tumor) were included in this review-board approved prospective pilot study between 08/14 and 02/15. Vacuum-assisted-biopsy (VAB) was performed after NACT and before surgery. Negative predictive values (NPV) and false-negative-rates (FNR) to predict a pCR in surgical specimen (=diagnose pCR through VAB) were the main outcome measures.
Results:
The cohort (n=50) consisted of 15 (30%) triple negative (TNBC), 13 (26%) HER2 positive (HER2+) and 22 (44%) hormone receptor positive / HER2 negative (HR+/HER2-) cancers. pCR in surgical specimen was diagnosed in 23 (46%) cases of the whole cohort. The NPV of the VAB diagnosis of pCR was 94.4% (95% CI: [0.84; 1.00]). The FNR was 3.7% (95% CI: [0; 0.12]) and specificity 73.9% (95% CI: [0.54; 0.94]). Taking only those biopsies into account that pathology confirmed to be representative of the (former) tumor region, improved the outcome of VAB to a specificity of 100% while the NPV (94.4% (95% CI: [0.84; 1.00]) and the FNR (4.8% (95% CI: [0.00; 0.15]) stayed the same.
Conclusion:
Overall accuracy of VAB diagnosis of pCR questions the necessity of surgical intervention to diagnose a pCR. A confirmative, multi-center, intra-individually-controlled clinical trial including patients with clinical complete, near complete or partial response to NACT to validate the above mentioned results is warranted.
Citation Format: Hennigs A, Heil J. Diagnosis of pathological complete response by vacuum-assisted minimal invasive biopsy after neoadjuvant chemotherapy in breast cancer - Results from a prospective pilot study. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P5-02-01.
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Affiliation(s)
- A Hennigs
- Universitäts-Frauenklinik, Heidelberg, Baden-Württemberg, Germany
| | - J Heil
- Universitäts-Frauenklinik, Heidelberg, Baden-Württemberg, Germany
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van Dam P, Tomatis M, Marotti L, Heil J, Wilson R, Rosselli del Turco M, Mayr C, Costa A, Danei M, Denk A, Emons G, Friedrichs K, Harbeck N, Kiechle M, Koheler U, Kuemmel S, Maass N, Marth C, Prové A, Kimmig R, Rageth C, Regolo L, Salehi L, Sarlos D, Singer C, Sohn C, Staelens G, Tinterri C, Ponti A, Cretella E, Kern P, Stoeblen F, Emons A, van Eygen K, Ettl J, Zanini V, Van As A, Daniaux M, Gatzemeier W, Catalano G, Schneeweiss A, Wuerstlein R. The effect of EUSOMA certification on quality of breast cancer care. Eur J Surg Oncol 2015; 41:1423-9. [DOI: 10.1016/j.ejso.2015.06.006] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2015] [Revised: 06/04/2015] [Accepted: 06/12/2015] [Indexed: 12/12/2022] Open
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Heil J, Kümmel S, Schaefgen B, Paepke S, Thomssen C, Rauch G, Ataseven B, Große R, Dreesmann V, Kühn T, Loibl S, Blohmer J, Minckwitz G. 1830 Diagnosis of pathological complete response to neoadjuvant chemotherapy in breast cancer by minimal invasive biopsy techniques. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)30781-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Vetter L, Keller M, Bruckner T, Evers C, Dikow N, Sohn C, Heil J, Schott S. Akzeptanz des intensivierten Früherkennungs- und Nachsorgeprogramms (IFNP) für familiären Brust- und Eierstockkrebs an der Universitätsfrauenklinik Heidelberg – Erste Ergebnisse. Geburtshilfe Frauenheilkd 2015. [DOI: 10.1055/s-0035-1555088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Rauh C, Schuetz F, Rack B, Stickeler E, Klar M, Orlowska-Volk M, Windfuhr-Blum M, Heil J, Rom J, Sohn C, Andergassen U, Jueckstock J, Fehm T, Loehberg CR, Hein A, Schulz-Wendtland R, Hartmann A, Beckmann MW, Janni W, Fasching PA, Häberle L. Hormone Therapy and its Effect on the Prognosis in Breast Cancer Patients. Geburtshilfe Frauenheilkd 2015; 75:588-596. [PMID: 26166840 DOI: 10.1055/s-0035-1546149] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [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: 05/02/2015] [Revised: 05/02/2015] [Accepted: 05/19/2015] [Indexed: 12/23/2022] Open
Abstract
Introduction: Use of hormone therapy (HT) has declined dramatically in recent years. Some studies have reported that HT use before a diagnosis of breast cancer (BC) may be a prognostic factor in postmenopausal patients. This study aimed to examine the prognostic relevance of HT use before BC diagnosis. Methods: Four BC cohort studies in Germany were pooled, and 4492 postmenopausal patients with HT use data were identified. Patient data and tumor characteristics were compared between users and nonusers, along with overall survival (OS), distant metastasis-free survival (DMFS), and local recurrence-free survival (LRFS). Cox proportional hazards models were stratified by study center and adjusted for age at diagnosis, tumor stage, grading, nodal status, and hormone receptors. Results: Women with HT use before the diagnosis of BC were more likely to have a lower tumor stage, to be estrogen receptor-negative, and to have a lower grading. With regard to prognosis there were effects seen for OS, DMFS and LRFS, specifically in the subgroup of women with a positive hormone receptor. In these subgroups, BC patients had a better prognosis with previous HT use. Conclusions: HT use before a diagnosis of BC is associated with a more favorable prognosis in women with a positive hormone receptor status. It may be recommended that the prognostic factor HT should be documented and analyzed as a confounder for prognosis in studies of postmenopausal hormone-responsive breast cancers.
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Affiliation(s)
- C Rauh
- University Breast Center, Department of Gynecology and Obstetrics, Erlangen University Hospital, Comprehensive Cancer Center EMN, Erlangen
| | - F Schuetz
- Breast Unit, Department of Gynecology and Obstetrics, Heidelberg University Hospital
| | - B Rack
- Department of Gynecology and Obstetrics, Campus Innenstadt University Hospital, Ludwig Maximilian University, Munich
| | - E Stickeler
- Department of Obstetrics and Gynecology, Freiburg University Medical Center, Freiburg
| | - M Klar
- Department of Obstetrics and Gynecology, Freiburg University Medical Center, Freiburg
| | - M Orlowska-Volk
- Institute of Pathology, Freiburg University Medical Center, Freiburg
| | - M Windfuhr-Blum
- Department of Radiology, Freiburg University Medical Center, Freiburg
| | - J Heil
- Breast Unit, Department of Gynecology and Obstetrics, Heidelberg University Hospital
| | - J Rom
- Breast Unit, Department of Gynecology and Obstetrics, Heidelberg University Hospital
| | - C Sohn
- Breast Unit, Department of Gynecology and Obstetrics, Heidelberg University Hospital
| | - U Andergassen
- Department of Gynecology and Obstetrics, Campus Innenstadt University Hospital, Ludwig Maximilian University, Munich
| | - J Jueckstock
- Department of Gynecology and Obstetrics, Campus Innenstadt University Hospital, Ludwig Maximilian University, Munich
| | - T Fehm
- Department of Gynecology and Obstetrics, Duesseldorf University Hospital, Düsseldorf
| | - C R Loehberg
- University Breast Center, Department of Gynecology and Obstetrics, Erlangen University Hospital, Comprehensive Cancer Center EMN, Erlangen
| | - A Hein
- University Breast Center, Department of Gynecology and Obstetrics, Erlangen University Hospital, Comprehensive Cancer Center EMN, Erlangen
| | - R Schulz-Wendtland
- Institute of Diagnostic Radiology, University Breast Center, Erlangen University Hospital, Comprehensive Cancer Center EMN, Erlangen
| | - A Hartmann
- Institute of Pathology, University Breast Center, Erlangen University Hospital, Comprehensive Cancer Center EMN, Erlangen
| | - M W Beckmann
- University Breast Center, Department of Gynecology and Obstetrics, Erlangen University Hospital, Comprehensive Cancer Center EMN, Erlangen
| | - W Janni
- Department of Gynecology and Obstetrics, Ulm University Hospital, Ulm
| | - P A Fasching
- University Breast Center, Department of Gynecology and Obstetrics, Erlangen University Hospital, Comprehensive Cancer Center EMN, Erlangen ; Department of Medicine, Division of Hematology and Oncology, David Geffen School of Medicine, University of California at Los Angeles, USA
| | - L Häberle
- University Breast Center, Department of Gynecology and Obstetrics, Erlangen University Hospital, Comprehensive Cancer Center EMN, Erlangen ; Biostatistics Unit, Department of Gynecology and Obstetrics, Erlangen University Hospital, Erlangen
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Friedrich OL, Lechler S, Rahmfeld T, Golatta M, Sohn C, Schütz F, Heil J. Abweichungen von Tumorboard-Empfehlungen des Mammografie-Screenings Rhein-Neckar und des Universitäts-Brustzentrums Heidelberg. Geburtshilfe Frauenheilkd 2014. [DOI: 10.1055/s-0034-1388434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Vetter L, Keller M, Bruckner T, Evers C, Dikow N, Sohn C, Heil J, Schott S. Akzeptanz des intensivierten Früherkennungs- und Nachsorgeprogramms (IFNP) für familiären Brust- und Eierstockkrebs an der Universitätsfrauenklinik Heidelberg – erste Ergebnisse. Geburtshilfe Frauenheilkd 2014. [DOI: 10.1055/s-0034-1388424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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49
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Hennigs A, Fuchs V, Rauch G, Golatta M, Smetanay K, Schneeweiss A, Sinn HP, Sohn C, Heil J. Einfluss von Nachresektion auf das Lokalrezidivrisiko bei Patientinnen mit Mammakarzinom nach brusterhaltender Therapie. Geburtshilfe Frauenheilkd 2014. [DOI: 10.1055/s-0034-1388553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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50
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Wallwiener M, Hartkopf AD, Riethdorf S, Nees J, Taran FA, Schönfisch B, Heil J, Sohn C, Pantel K, Trumpp A, Schneeweiss A. The impact of HER2 phenotype of circulating tumor cells in metastatic breast cancer: a study in 107 patients. Geburtshilfe Frauenheilkd 2014. [DOI: 10.1055/s-0034-1388600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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