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Paffenholz P, Landwehr G, Seidel C, Poch A, Bokemeyer C, Cathomas R, Pongratanakul P, Hiester A, Albers P, Pichler M, Krege S, Syring-Schmandke I, Heinzelbecker J, Nestler T, Pfister D, Heidenreich A. Non-seminomatous testicular germ cell tumours with teratoma-free primaries exhibit a superior early relapse-free survival. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00787-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: 02/12/2023]
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Huber K, Dreos R, Geller S, Barquissau V, Ziegler D, Tavernari D, Giralt A, Gallart-Ayala H, Ciriello G, Ivanisevic J, Pichler M, Fajas L. 57P Deciphering the role of E2F transcription factor-1 in glutamine metabolism. ESMO Open 2023. [DOI: 10.1016/j.esmoop.2023.100915] [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: 03/11/2023] Open
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Barth D, Sareban N, Lindner A, Daller L, Matzhold E, Hutterer G, Smolle M, Riedl J, Huemer M, Mannweiler S, Jost P, Bauernhofer T, Ahyai S, Zigeuner R, Pichler R, Pichler M. Influence of perioperative administration, transfusion volume and storage age of red blood cell concentrates on clinical outcomes in non-metastatic renal cell carcinoma patients. EUR UROL SUPPL 2022. [DOI: 10.1016/s2666-1683(22)01959-0] [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: 11/07/2022] Open
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Robinson I, Schmidinger M, Hochmair M, Ay L, Absenger G, Pichler M, Nguyen V, Richtig E, Rainer B, Jansen C, Sladek B, Knabl A, Gasche N, Valipour A. 117P BiomeOne: Multi-centric validation of a novel microbiome-based biomarker to predict response to cancer immunotherapy. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.149] [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: 11/01/2022] Open
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Grabenhofer-Eggerth A, Ladurner J, Pichler M, Gaiswinkler S. Supporting the development of strategies of suicide prevention based on experience and lessons learned from Austria. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab164.242] [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: 11/12/2022] Open
Abstract
Abstract
The Austrian programme “Suicide Prevention Austria (SUPRA)” was selected as a best practice example to be implemented in other European countries as part of the Joint Action ImpleMENTAL. The main objective of the dedicated work package on SUPRA is to develop and/or scale up the suicide prevention strategies of the participating countries based on the best practice example, ensuring that specific components of SUPRA are carefully selected, taking into account the respective country context. To gain an in-depth understanding of the current situation and required resources in the field of suicide prevention in each participating country or region, a Situation and Needs Analysis (SANA) will be conducted. National/regional working groups will be trained and assisted in identifying elements of SUPRA to be pilot implemented, based on the results of the SANA and the priorities within the participating countries. Components of SUPRA include: (i) ensuring that suicide prevention is organisationally embedded and co-ordinated), (ii) support and treatment of high risk groups according to their specific needs, (iii) restriction of access to means of suicide with the aim of making access as difficult as possible), (iv) ensuring that awareness and knowledge of suicidality and about coping with psychosocial crises are widespread among the general population), (v) integrating suicide prevention programmes into other existing health promotion activities and into addiction and violence prevention measures, (vi) quality assurance of suicide prevention on the basis of scientific expertise and evidence. Participating countries are supported in developing draft national/regional strategies and in initiating (first steps towards) pilot-implementation of selected suicide prevention interventions through workshops, training sessions and webinars.
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Affiliation(s)
- A Grabenhofer-Eggerth
- Department Psychosocial Health, Austrian National Public Health Institute, Vienna, Austria
| | - J Ladurner
- Department Psychosocial Health, Austrian National Public Health Institute, Vienna, Austria
| | - M Pichler
- Department Psychosocial Health, Austrian National Public Health Institute, Vienna, Austria
| | - S Gaiswinkler
- Department Health, Society and Equity, Austrian National Public Health Institute, Vienna, Austria
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Stelzer CP, Blommaert J, Waldvogel AM, Pichler M, Hecox-Lea B, Mark Welch DB. Comparative analysis reveals within-population genome size variation in a rotifer is driven by large genomic elements with highly abundant satellite DNA repeat elements. BMC Biol 2021; 19:206. [PMID: 34530817 PMCID: PMC8447722 DOI: 10.1186/s12915-021-01134-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 08/27/2021] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Eukaryotic genomes are known to display an enormous variation in size, but the evolutionary causes of this phenomenon are still poorly understood. To obtain mechanistic insights into such variation, previous studies have often employed comparative genomics approaches involving closely related species or geographically isolated populations within a species. Genome comparisons among individuals of the same population remained so far understudied-despite their great potential in providing a microevolutionary perspective to genome size evolution. The rotifer Brachionus asplanchnoidis represents one of the most extreme cases of within-population genome size variation among eukaryotes, displaying almost twofold variation within a geographic population. RESULTS Here, we used a whole-genome sequencing approach to identify the underlying DNA sequence differences by assembling a high-quality reference genome draft for one individual of the population and aligning short reads of 15 individuals from the same geographic population including the reference individual. We identified several large, contiguous copy number variable regions (CNVs), up to megabases in size, which exhibited striking coverage differences among individuals, and whose coverage overall scaled with genome size. CNVs were of remarkably low complexity, being mainly composed of tandemly repeated satellite DNA with only a few interspersed genes or other sequences, and were characterized by a significantly elevated GC-content. CNV patterns in offspring of two parents with divergent genome size and CNV patterns in several individuals from an inbred line differing in genome size demonstrated inheritance and accumulation of CNVs across generations. CONCLUSIONS By identifying the exact genomic elements that cause within-population genome size variation, our study paves the way for studying genome size evolution in contemporary populations rather than inferring patterns and processes a posteriori from species comparisons.
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Affiliation(s)
- C P Stelzer
- Research Department for Limnology, University of Innsbruck, Mondsee, Austria.
| | - J Blommaert
- Research Department for Limnology, University of Innsbruck, Mondsee, Austria
- Department of Organismal Biology, Uppsala University, Uppsala, Sweden
| | - A M Waldvogel
- Institute of Zoology, University of Cologne, Cologne, Germany
| | - M Pichler
- Research Department for Limnology, University of Innsbruck, Mondsee, Austria
| | - B Hecox-Lea
- Josephine Bay Paul Center for Comparative Molecular Biology and Evolution, Marine Biological Laboratory, Woods Hole, MA, USA
| | - D B Mark Welch
- Josephine Bay Paul Center for Comparative Molecular Biology and Evolution, Marine Biological Laboratory, Woods Hole, MA, USA
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7
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Pichler M, Steyrer J. Cost-effectiveness analysis of the use of immunotherapy in metastatic solid tumours in Austria by applying the ESMO-Magnitude of Clinical Benefit Scale (ESMO-MCBS) version 1.1. ESMO Open 2021; 6:100198. [PMID: 34175674 PMCID: PMC8253953 DOI: 10.1016/j.esmoop.2021.100198] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 02/09/2021] [Revised: 05/17/2021] [Accepted: 05/31/2021] [Indexed: 11/23/2022] Open
Abstract
Background Immune checkpoint inhibitors (ICIs) treatment is a breakthrough in managing metastatic solid tumours, but its use is associated with a high financial burden for public health care systems. Validated tools such as the European Society for Medical Oncology-Magnitude of Clinical Benefit Scale (ESMO-MCBS) are frameworks that might help to better assess the clinical benefit of these novel innovative cancer drugs. Methods Here, we systematically analysed the number of European Medicines Agency-approved ICIs labels with an ESMO-MCBS grade <4 and the impact of the ICIs on incremental costs, gain of life years (LYs), quality-adjusted life years (QALYs) and the incremental cost-effectiveness ratio in the Austrian population. Results Of 23 ICIs treatment settings, we identified three clinical scenarios in metastatic solid cancers with an ESMO-MCBS grade <4 with no otherwise approved alternatives. In triple-negative breast cancer (TNBC), the addition of first-line atezolizumab increased QALYs by 0.33 compared with nab-paclitaxel only, with an incremental cost per QALY of €143 853. In small-cell lung cancer (SCLC), the addition of first-line atezolizumab increased the QALY by 0.09, with an incremental cost per QALY of €373 256, and the addition of first-line durvalumab increased the QALYs by 0.11, with an incremental cost per QALY of €589 527. Conclusions Overall, most of the approved ICIs carry significant clinical benefit (≥4). Although TNBC and SCLC are challenging treatment scenarios, currently approved ICIs with an ESMO-MCBS grade <4 substantially increase the cost of medical treatment, and under a willingness-to-pay threshold of €100 000, they do not have a cost-effective comparative benefit. Most European Medicines Agency-approved ICIs have an ESMO-MCBS with significant clinical benefit. In hard-to-treat types of cancer such as TNBC or SCLC, the ESMO-MCBS is <4. Under a willingness-to-pay threshold of €100.000, they do not have a cost-effective comparative benefit in Austria.
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Affiliation(s)
- M Pichler
- Division of Oncology, Department of Internal Medicine, Medical University of Graz, Graz, Austria; Interdisciplinary Institute for Management and Organizational Behaviour, Vienna University of Economics and Business, Wien, Austria.
| | - J Steyrer
- Interdisciplinary Institute for Management and Organizational Behaviour, Vienna University of Economics and Business, Wien, Austria
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8
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Dietz J, Spengler U, Müllhaupt B, Schulze Zur Wiesch J, Piecha F, Mauss S, Seegers B, Hinrichsen H, Antoni C, Wietzke-Braun P, Peiffer KH, Berger A, Matschenz K, Buggisch P, Backhus J, Zizer E, Boettler T, Neumann-Haefelin C, Semela D, Stauber R, Berg T, Berg C, Zeuzem S, Vermehren J, Sarrazin C, Giostra E, Berning M, Hampe J, De Gottardi A, Rauch A, Semmo N, Discher T, Trauth J, Fischer J, Gress M, Günther R, Heinzow H, Schmidt J, Herrmann A, Stallmach A, Hilgard G, Deterding K, Lange C, Ciesek S, Wedemeyer H, Hoffmann D, Klinker H, Schulze P, Kocheise F, Müller-Schilling M, Kodal A, Kremer A, Ganslmayer M, Siebler J, Lammert F, Rissland J, Löbermann M, Götze T, Canbay A, Lohse A, von Felden J, Jordan S, Maieron A, Moradpour D, Chave JP, Moreno C, Müller T, Muche M, Epple HJ, Port K, von Hahn T, Cornberg M, Manns M, Reinhardt L, Ellenrieder V, Rockstroh J, Schattenberg J, Sprinzl M, Galle P, Roeb E, Steckstor M, Schmiegel W, Brockmeyer N, Seufferlein T, Stremmel W, Strey B, Thimme R, Teufel A, Vogelmann R, Ebert M, Tomasiewicz K, Trautwein C, Tacke F, Koenen T, Weber T, Zachoval R, Mayerle J, Raziorrouh B, Angeli W, Beckebaum S, Doberauer C, Durmashkina E, Hackelsberger A, Erhardt A, Garrido-Lüneburg A, Gattringer H, Genné D, Gschwantler M, Gundling F, Hametner S, Schöfl R, Hartmann C, Heyer T, Hirschi C, Jussios A, Kanzler S, Kordecki N, Kraus M, Kullig U, Wollschläger S, Magenta L, Beretta-Piccoli BT, Menges M, Mohr L, Muehlenberg K, Niederau C, Paulweber B, Petrides A, Pinkernell M, Piso R, Rambach W, Reiser M, Riecken B, Rieke A, Roth J, Schelling M, Schlee P, Schneider A, Scholz D, Schott E, Schuchmann M, Schulten-Baumer U, Seelhoff A, Stich A, Stickel F, Ungemach J, Walter E, Weber A, Winzer T, Abels W, Adler M, Audebert F, Baermann C, Bästlein E, Barth R, Barthel K, Becker W, Behrends J, Benninger J, Berger F, Berzow D, Beyer T, Bierbaum M, Blaukat O, Bodtländer A, Böhm G, Börner N, Bohr U, Bokemeyer B, Bruch H, Bucholz D, Burkhard O, Busch N, Chirca C, Delker R, Diedrich J, Frank M, Diehl M, Dienethal A, Dietel P, Dikopoulos N, Dreck M, Dreher F, Drude L, Ende K, Ehrle U, Baumgartl K, Emke F, Glosemeyer R, Felten G, Hüppe D, Fischer J, Fischer U, Frederking D, Frick B, Friese G, Gantke B, Geyer P, Schwind H, Glas M, Glaunsinger T, Goebel F, Göbel U, Görlitz B, Graf R, Gruber H, Härter G, Herder M, Heuchel T, Heuer S, Höffl KH, Hörster H, Sonne JU, Hofmann W, Holst F, Hunstiger M, Hurst A, Jägel-Guedes E, John C, Jung M, Kallinowski B, Kapzan B, Kerzel W, Khaykin P, Klarhof M, Klüppelberg U, Klugewitz K, Knapp B, Knevels U, Kochsiek T, Körfer A, Köster A, Kuhn M, Langekamp A, Künzig B, Link R, Littman M, Löhr H, Lutz T, Knecht G, Lutz U, Mainz D, Mahle I, Maurer P, Mayer C, Meister V, Möller H, Heyne R, Moritzen D, Mroß M, Mundlos M, Naumann U, Nehls O, Ningel K, Oelmann A, Olejnik H, Gadow K, Pascher E, Petersen J, Philipp A, Pichler M, Polzien F, Raddant R, Riedel M, Rietzler S, Rössle M, Rufle W, Rump A, Schewe C, Hoffmann C, Schleehauf D, Schmidt K, Schmidt W, Schmidt-Heinevetter G, Schmidtler-von Fabris J, Schnaitmann E, Schneider L, Schober A, Niehaus-Hahn S, Schwenzer J, Seidel T, Seitel G, Sick C, Simon K, Stähler D, Stenschke F, Steffens H, Stein K, Steinmüller M, Sternfeld T, Strey B, Svensson K, Tacke W, Teuber G, Teubner K, Thieringer J, Tomesch A, Trappe U, Ullrich J, Urban G, Usadel S, von Lucadou A, Weinberger F, Werheid-Dobers M, Werner P, Winter T, Zehnter E, Zipf A. Efficacy of Retreatment After Failed Direct-acting Antiviral Therapy in Patients With HCV Genotype 1-3 Infections. Clin Gastroenterol Hepatol 2021; 19:195-198.e2. [PMID: 31706062 DOI: 10.1016/j.cgh.2019.10.051] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 09/19/2019] [Accepted: 10/25/2019] [Indexed: 02/07/2023]
Abstract
Hepatitis C virus infection is causing chronic liver disease, cirrhosis, and hepatocellular carcinoma. By combining direct-acting antivirals (DAAs), high sustained virologic response rates (SVRs) can be achieved. Resistance-associated substitutions (RASs) are commonly observed after DAA failure, and especially nonstructural protein 5A (NS5A) RASs may impact retreatment options.1-3 Data on retreatment of DAA failure patients using first-generation DAAs are limited.4-7 Recently, a second-generation protease- and NS5A-inhibitor plus sofosbuvir (voxilaprevir/velpatasvir/sofosbuvir [VOX/VEL/SOF]) was approved for retreatment after DAA failure.8 However, this and other second-generation regimens are not available in many resource-limited countries or are not reimbursed by regular insurance, and recommendations regarding the selection of retreatment regimens using first-generation DAAs are very important. This study aimed to analyze patients who were re-treated with first-generation DAAs after failure of a DAA combination therapy.
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Affiliation(s)
- Julia Dietz
- Department of Internal Medicine 1, University Hospital Frankfurt, Goethe University, Frankfurt, and German Center for Infection Research (DZIF), External Partner Site, Frankfurt, Germany
| | - Ulrich Spengler
- Department of Internal Medicine I, University of Bonn, Bonn, and German Center for Infection Research (DZIF), Partner Site, Cologne-Bonn, Germany
| | - Beat Müllhaupt
- Swiss Hepato-Pancreato-Biliary Center and Department of Gastroenterology and Hepatology, University Hospital Zürich, Zürich, Switzerland
| | - Julian Schulze Zur Wiesch
- I. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, and German Center for Infection Research (DZIF), Partner Site, Hamburg-Lübeck-Borstel-Riems, Germany
| | - Felix Piecha
- I. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, and German Center for Infection Research (DZIF), Partner Site, Hamburg-Lübeck-Borstel-Riems, Germany
| | - Stefan Mauss
- Center for HIV and Hepatogastroenterology, Düsseldorf, Germany
| | - Barbara Seegers
- Gastroenterologisch-Hepatologisches Zentrum Kiel, Kiel, Germany
| | | | - Christoph Antoni
- Department of Internal Medicine II, University Hospital Mannheim, Mannheim, Germany
| | | | - Kai-Henrik Peiffer
- Department of Internal Medicine 1, University Hospital Frankfurt, Goethe University, Frankfurt, and German Center for Infection Research (DZIF), External Partner Site, Frankfurt, Germany
| | - Annemarie Berger
- Institute for Medical Virology, University Hospital Frankfurt, Frankfurt, Germany
| | | | - Peter Buggisch
- Institute for Interdisciplinary Medicine IFI, Hamburg, Germany
| | - Johanna Backhus
- Department of Internal Medicine I, Ulm University, Ulm, Germany
| | - Eugen Zizer
- Department of Internal Medicine I, Ulm University, Ulm, Germany
| | - Tobias Boettler
- Department of Medicine II, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Christoph Neumann-Haefelin
- Department of Medicine II, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - David Semela
- Division of Gastroenterology and Hepatology, Kantonsspital St Gallen, St Gallen, Switzerland
| | - Rudolf Stauber
- Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Thomas Berg
- Department of Gastroenterology and Rheumatology, University Hospital Leipzig, Leipzig, Germany
| | - Christoph Berg
- Department of Internal Medicine I, University of Tübingen, Tübingen, Germany
| | - Stefan Zeuzem
- Department of Internal Medicine 1, University Hospital Frankfurt, Goethe University, Frankfurt, and German Center for Infection Research (DZIF), External Partner Site, Frankfurt, Germany
| | - Johannes Vermehren
- Department of Internal Medicine 1, University Hospital Frankfurt, Goethe University, Frankfurt, and German Center for Infection Research (DZIF), External Partner Site, Frankfurt, Germany
| | - Christoph Sarrazin
- Department of Internal Medicine 1, University Hospital Frankfurt, Goethe University, Frankfurt, and German Center for Infection Research (DZIF), External Partner Site, Frankfurt, Germany; Medizinische Klinik 2, St Josefs-Hospital, Wiesbaden, Germany.
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Posch F, Barth D, Brueckl W, Zeitler G, Foris V, Mollnar S, Stotz M, Rossmann C, Terbuch A, Balic M, Niedrist T, Bertsch T, Stöger H, Pichler M, Olschewski H, Absenger G, Ficker J, Gerger A, Riedl J. 113P C-reactive protein (CRP) levels in immune checkpoint inhibitor response and progression in advanced non-small cell lung cancer: A bi-center study. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.234] [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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Riedl J, Posch F, Horvath L, Gantschnigg A, Renneberg F, Schwarzenbacher E, Moik F, Barth D, Stotz M, Schaberl-Moser R, Pichler M, Stöger H, Greil R, Djanani A, Schlick K, Gerger A. 1530P Gemcitabine/nab-paclitaxel versus (modified) FOLFIRINOX for palliative first-line treatment of advanced pancreatic cancer: A propensity score analysis. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.2013] [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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Mollnar S, Pondorfer P, Kasparek AK, Reinisch S, Moik F, Stotz M, Halm M, Szkandera J, Terbuch A, Eisner F, Gerger A, Kapp KS, Partl R, Vasicek S, Weiland T, Pichler M, Stöger H, Thurnher D, Posch F. Decrease in treatment intensity predicts worse outcome in patients with locally advanced head and neck squamous cell carcinoma undergoing radiochemotherapy. Clin Transl Oncol 2020; 23:543-553. [PMID: 32671728 PMCID: PMC7936960 DOI: 10.1007/s12094-020-02447-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 11/14/2019] [Accepted: 07/02/2020] [Indexed: 12/30/2022]
Abstract
Purpose Radiochemotherapy (RCT) is an effective standard therapy for locally advanced head and neck squamous cell carcinoma (LA-HNSCC). Nonetheless, toxicity is common, with patients often requiring dose modifications. Methods To investigate associations of RCT toxicities according to CTCAE version 5.0 and subsequent therapy modifications with short- and long-term treatment outcomes, we studied all 193 patients with HNSCC who received RCT (70 Gy + platinum agent) at an academic center between 03/2010 and 04/2018. Results During RCT, 77 (41%, 95% CI 34–49) patients developed at least one ≥ grade 3 toxicity, including seven grade 4 and 3 fatal grade 5 toxicities. The most frequent any-grade toxicities were xerostomia (n = 187), stomatitis (n = 181), dermatitis (n = 174), and leucopenia (n = 98). Eleven patients (6%) had their radiotherapy schedule modified (mean radiotherapy dose reduction = 12 Gy), and 120 patients (64%) had chemotherapy modifications (permanent discontinuation: n = 67, pause: n = 34, dose reduction: n = 7, change to other chemotherapy: n = 10). Objective response rates to RCT were 55% and 88% in patients with and without radiotherapy modifications (p = 0.003), and 84% and 88% in patients with and without chemotherapy modifications (p = 0.468), respectively. Five-year progression-free survival estimates were 20% and 50% in patients with and without radiotherapy modifications (p = < 0.001), and 53% and 40% in patients with and without chemotherapy modifications (p = 0.88), respectively. Conclusions Reductions of radiotherapy dose were associated with impaired long-term outcomes, whereas reductions in chemotherapy intensity were not. This suggests that toxicities during RCT should be primarily managed by modifying chemotherapy rather than radiotherapy. Electronic supplementary material The online version of this article (10.1007/s12094-020-02447-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- S Mollnar
- Division of Oncology, Department of Internal Medicine, Comprehensive Cancer Center Graz, Medical University of Graz, Auenbruggerplatz 15, 8036, Graz, Austria
| | - P Pondorfer
- Division of General Otorhinolaryngology, Head and Neck Surgery, Department of Otorhinolaryngology; Comprehensive Cancer Center Graz, Medical University of Graz, Graz, Austria
| | - A-K Kasparek
- Division of Oncology, Department of Internal Medicine, Comprehensive Cancer Center Graz, Medical University of Graz, Auenbruggerplatz 15, 8036, Graz, Austria
| | - S Reinisch
- Division of General Otorhinolaryngology, Head and Neck Surgery, Department of Otorhinolaryngology; Comprehensive Cancer Center Graz, Medical University of Graz, Graz, Austria
| | - F Moik
- Division of Oncology, Department of Internal Medicine, Comprehensive Cancer Center Graz, Medical University of Graz, Auenbruggerplatz 15, 8036, Graz, Austria
| | - M Stotz
- Division of Oncology, Department of Internal Medicine, Comprehensive Cancer Center Graz, Medical University of Graz, Auenbruggerplatz 15, 8036, Graz, Austria
| | - M Halm
- Division of Oncology, Department of Internal Medicine, Comprehensive Cancer Center Graz, Medical University of Graz, Auenbruggerplatz 15, 8036, Graz, Austria
| | - J Szkandera
- Division of Oncology, Department of Internal Medicine, Comprehensive Cancer Center Graz, Medical University of Graz, Auenbruggerplatz 15, 8036, Graz, Austria
| | - A Terbuch
- Division of Oncology, Department of Internal Medicine, Comprehensive Cancer Center Graz, Medical University of Graz, Auenbruggerplatz 15, 8036, Graz, Austria
| | - F Eisner
- Division of Oncology, Department of Internal Medicine, Comprehensive Cancer Center Graz, Medical University of Graz, Auenbruggerplatz 15, 8036, Graz, Austria
| | - A Gerger
- Division of Oncology, Department of Internal Medicine, Comprehensive Cancer Center Graz, Medical University of Graz, Auenbruggerplatz 15, 8036, Graz, Austria
- Center for Biomarker Research in Medicine (CBmed), Graz, Austria
| | - K S Kapp
- Department of Therapeutic Radiology and Oncology, Comprehensive Cancer Center Graz, Medical University of Graz, Graz, Austria
| | - R Partl
- Department of Therapeutic Radiology and Oncology, Comprehensive Cancer Center Graz, Medical University of Graz, Graz, Austria
| | - S Vasicek
- Division of General Otorhinolaryngology, Head and Neck Surgery, Department of Otorhinolaryngology; Comprehensive Cancer Center Graz, Medical University of Graz, Graz, Austria
| | - T Weiland
- Division of General Otorhinolaryngology, Head and Neck Surgery, Department of Otorhinolaryngology; Comprehensive Cancer Center Graz, Medical University of Graz, Graz, Austria
| | - M Pichler
- Division of Oncology, Department of Internal Medicine, Comprehensive Cancer Center Graz, Medical University of Graz, Auenbruggerplatz 15, 8036, Graz, Austria
- Research Unit "Non-Coding RNAs and Genome Editing in Cancer", Medical University of Graz, Graz, Austria
- Department of Experimental Therapeutics, MD Anderson Cancer Center, Houston, TX, USA
| | - H Stöger
- Division of Oncology, Department of Internal Medicine, Comprehensive Cancer Center Graz, Medical University of Graz, Auenbruggerplatz 15, 8036, Graz, Austria
| | - D Thurnher
- Division of General Otorhinolaryngology, Head and Neck Surgery, Department of Otorhinolaryngology; Comprehensive Cancer Center Graz, Medical University of Graz, Graz, Austria
| | - F Posch
- Division of Oncology, Department of Internal Medicine, Comprehensive Cancer Center Graz, Medical University of Graz, Auenbruggerplatz 15, 8036, Graz, Austria.
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12
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Klec C, Schwarzenbacher D, Gottschalk B, Margit R, Prinz F, Bauernhofer T, Stoeger H, Graier W, Pichler M. 68P Deciphering the interplay between nuclear RNA export factors and long non-coding RNAs in breast cancer metabolism. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.03.202] [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: 11/27/2022] Open
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13
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Posch F, Glantschnig T, Firla S, Smolle M, Balic M, Moik F, Stoeger H, Zirlik A, Pichler M, Rainer P. P6237Clinical utility of echocardiographic left-ventricular ejection fraction monitoring for cardiotoxicity risk assessment in patients with HER2+ early breast cancer undergoing trastuzumab-based therapy. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0838] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Monitoring left-ventricular ejection fraction (LVEF) is a routinely-practiced strategy to survey patients with breast cancer (BC) towards cardiotoxic treatment effects. However, whether the LVEF as a single measurement or as a trajectory over time is truly sufficient to identify patients at high risk for cardiotoxicity is currently debated.
Purpose
To quantify the prognostic impact of LVEF and its change over time for predicting cardiotoxicity in women with HER2+ early BC.
Methods
We analyzed 1,136 echocardiography reports from 185 HER2+ early BC patients treated with trastuzumab ± chemoimmunoendocrine therapy in the neoadjuvant/adjuvant setting (Table 1). Cardiotoxicity was defined as a 10% decline in LVEF below 50%.
Results
Median baseline LVEF was 64% (25th-75th percentile: 60–69). Nineteen patients (10%) experienced cardiotoxicity (asymptomatic n=12, symptomatic n=7, during treatment n=19, treatment modification/termination n=14), Median time to cardiotoxicity was 6.7 months, and median LVEF decline in patients with cardiotoxicity was 18%. One-year cardiotoxicity risk was 7.6% in the 35 patients with a baseline LVEF≥60% and 24.5% in the 150 patients with a baseline LVEF<60% (Hazard Ratio (HR)=3.45, 95% CI: 1.35–8.75, Figure 1). During treatment, LVEF declined significantly faster in patients who developed cardiotoxicity than in patients without cardiotoxicity (1.3%/month vs. 0.1%/month, p<0.0001). A higher rate of LVEF decrease predicted for higher cardiotoxicity risk (HR per 0.1%/month higher LVEF decrease/month=2.50, 95% CI: 1.31–4.76, p=0.005), and cardiotoxicity risk increased by a factor of 1.7 per 5% absolute LVEF decline from baseline to first follow-up (HR=1.70, 95% CI: 1.30–2.38, p<0.0001). Thirty-six patients (19%) developed an LVEF decline of at least 5% from baseline to first follow-up (“early LVEF decline”). One-year cardiotoxicity risk was 6.8% in those without early LVEF decline and a baseline LVEF≥60% (n=117), 15.7% in those without an early LVEF decline and a baseline LVEF<60% (n=65), and 66.7% in those with an early LVEF decline and a baseline LVEF<60% (n=3), respectively (log-rank p<0.0001).
Table 1. Baseline characteristics Age (years, median [IQR]) 55 [49–65] Estrogen receptor positive (n, %) 124 (67%) Neoadjuvant setting (n, %) 103 (56%)
Figure 1. Risk of Cardiotoxicity.
Conclusion
Both a single LVEF measurement and the rate of LVEF decrease strongly predict cardiotoxicity in early BC patients undergoing HER2-targeted therapy. Routine LVEF monitoring identifies individuals at high risk of cardiotoxicity that may benefit from more sensitive screening techniques such as strain imaging.
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Affiliation(s)
- F Posch
- Medical University of Graz, Department of Internal Medicine, Graz, Austria
| | - T Glantschnig
- Medical University of Graz, Department of Internal Medicine, Graz, Austria
| | - S Firla
- Medical University of Graz, Department of Internal Medicine, Graz, Austria
| | - M Smolle
- Medical University of Graz, Department of Internal Medicine, Graz, Austria
| | - M Balic
- Medical University of Graz, Department of Internal Medicine, Graz, Austria
| | - F Moik
- Medical University of Vienna, Department of Medicine I, Vienna, Austria
| | - H Stoeger
- Medical University of Graz, Department of Internal Medicine, Graz, Austria
| | - A Zirlik
- Medical University of Graz, Department of Internal Medicine, Graz, Austria
| | - M Pichler
- Medical University of Graz, Department of Internal Medicine, Graz, Austria
| | - P Rainer
- Medical University of Graz, Department of Internal Medicine, Graz, Austria
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14
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Leithner A, van Praag V, Posch F, Bergovec M, Leitner L, Friesenbichler J, Heregger R, Smolle-Jüttner FM, Fiocco M, van de Sande M, Riedl J, Pichler M, Gerger A, Szkandera J, Stöger H, Liegl-Atzwanger B, Smolle M. Efficacy of metastasectomy on survival in patients with metachronous soft tissue sarcoma-metastasis: Results of a bi-centre study including 135 patients. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy299.023] [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: 11/13/2022] Open
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15
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Lindenmann J, Fink-Neuboeck N, Fediuk M, Gschwandtner E, Swatek P, Strießnig A, Pichler M, Posch F, Stacher-Priehse E, Anegg U, Maier A, Smolle-Jüttner F. P-142PREDICTION OF CLINICAL OUTCOMES IN STAGE I NON-SMALL CELL LUNG CANCER AFTER CURATIVE SURGERY FOCUSING ON THE PREOPERATIVE GLASGOW PROGNOSTIC SCORE AND INFLAMMATORY BIOMARKERS. Interact Cardiovasc Thorac Surg 2017. [DOI: 10.1093/icvts/ivx280.142] [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: 11/14/2022] Open
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16
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Lindenmann J, Fink-Neuboeck N, Fediuk M, Gschwandtner E, Strießnig A, Swatek P, Pichler M, Posch F, Stacher-Priehse E, Anegg U, Maier A, Smolle-Jüttner F. P-109HOW LONG SHOULD WE FOLLOW UP PATIENTS WITH STAGE I NON-SMALL CELL LUNG CANCER AFTER CURATIVE RESECTION? AN ANALYSIS OF 300 CASES USING FLEXIBLE PARAMETRIC MODELLING OF TUMOUR RECURRENCE AND MORTALITY RATES. Interact Cardiovasc Thorac Surg 2017. [DOI: 10.1093/icvts/ivx280.109] [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: 11/13/2022] Open
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17
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Richtig G, Hoeller C, Kashofer K, Aigelsreiter A, Heinemann A, Kwong L, Pichler M, Richtig E. Beyond the BRAF
V
600E
hotspot: biology and clinical implications of rare BRAF
gene mutations in melanoma patients. Br J Dermatol 2017; 177:936-944. [DOI: 10.1111/bjd.15436] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/01/2017] [Indexed: 12/15/2022]
Affiliation(s)
- G. Richtig
- Institute of Experimental and Clinical Pharmacology; Medical University of Graz; Graz Austria
- Department of Dermatology; Medical University of Graz; Graz Austria
| | - C. Hoeller
- Department of Dermatology; Medical University of Vienna; Vienna Austria
| | - K. Kashofer
- Institute for Pathology; Medical University of Graz; Graz Austria
| | - A. Aigelsreiter
- Institute for Pathology; Medical University of Graz; Graz Austria
| | - A. Heinemann
- Institute of Experimental and Clinical Pharmacology; Medical University of Graz; Graz Austria
| | - L.N. Kwong
- Translational Molecular Pathology; The University of Texas MD Anderson Cancer Center; Houston TX U.S.A
| | - M. Pichler
- Division of Oncology; Medical University of Graz; Graz Austria
- Department of Experimental Therapeutics; The University of Texas MD Anderson Cancer Center; Houston TX U.S.A
| | - E. Richtig
- Department of Dermatology; Medical University of Graz; Graz Austria
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18
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Schneider C, Wallner M, Pichler M, Von Lewinski D, Sedej S, Rainer P. P5257The anti-cancer tyrosine kinase inhibitor sorafenib reduces cardiac contractile force by reducing cardiomyocyte calcium transient amplitude. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.p5257] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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19
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Richtig G, Richtig E, Kashofer K, Koch L, Winter G, Hoefler G, Pichler M, Ehall B, Grübler MR, Heinemann A, Aigelsreiter A. Testing and clinical implications for non-V600 BRAF mutations in metastatic NRAS mt melanoma. Br J Dermatol 2017; 177:860-861. [PMID: 27925152 DOI: 10.1111/bjd.15222] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- G Richtig
- Institute of Experimental and Clinical Pharmacology, Medical University of Graz, Graz, Austria.,Department of Dermatology, Medical University of Graz, Graz, Austria
| | - E Richtig
- Department of Dermatology, Medical University of Graz, Graz, Austria
| | - K Kashofer
- Institute of Pathology, Medical University of Graz, Graz, Austria
| | - L Koch
- Department of Dermatology, Medical University of Graz, Graz, Austria
| | - G Winter
- Institute of Pathology, Medical University of Graz, Graz, Austria
| | - G Hoefler
- Institute of Pathology, Medical University of Graz, Graz, Austria
| | - M Pichler
- Division of Oncology, Medical University of Graz, Graz, Austria
| | - B Ehall
- Institute of Pathology, Medical University of Graz, Graz, Austria
| | - M R Grübler
- Swiss Cardiovascular Center Bern, Department of Cardiology, Bern University Hospital, Bern, Switzerland.,Department of Internal Medicine (Division of Endocrinology and Diabetology), Medical University of Graz, Graz, Austria
| | - A Heinemann
- Institute of Experimental and Clinical Pharmacology, Medical University of Graz, Graz, Austria
| | - A Aigelsreiter
- Institute of Pathology, Medical University of Graz, Graz, Austria
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20
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Neumeister P, Fechter K, Deutsch A, Pichler M, Prochazka K, Feichtinger J, Steinbauer E, Greinix H, Beham-Schmid C. Cytoplasmatic location of NR4A1 in aggressive lymphomas is associated with a favourable cancer specific survival. Hematol Oncol 2017. [DOI: 10.1002/hon.2439_25] [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: 11/08/2022]
Affiliation(s)
- P. Neumeister
- Department of Internal Medicine; Division of Hematology; Graz Austria
| | - K. Fechter
- Department of Internal Medicine; Division of Hematology; Graz Austria
| | - A. Deutsch
- Department of Internal Medicine; Division of Hematology; Graz Austria
| | - M. Pichler
- Department of Internal Medicine; Division of Oncology; Graz Austria
| | - K. Prochazka
- Department of Internal Medicine; Division of Hematology; Graz Austria
| | - J. Feichtinger
- Institute of Molecular Biotechnology; University of Technology; Graz Austria
| | - E. Steinbauer
- Hematopathology; Institute of Pathology; Graz Austria
| | - H. Greinix
- Department of Internal Medicine; Division of Hematology; Graz Austria
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Abstract
Status epilepticus is a neurologic and medical emergency manifested by prolonged seizure activity or multiple seizures without return to baseline. It is associated with substantial medical cost, morbidity, and mortality. There is a spectrum of severity dependent on the type of seizure, underlying pathology, comorbidities, and appropriate and timely medical management. This chapter discusses the evolving definitions of status epilepticus and multiple patient and clinical factors which influence outcome. The pathophysiology of status epilepticus is reviewed to provide a better understanding of the mechanisms which contribute to status epilepticus, as well as the potential long-term effects. The clinical presentations of different types of status epilepticus in adults are discussed, with emphasis on the hospital course and management of the most dangerous type, generalized convulsive status epilepticus. Strategies for the evaluation and management of status epilepticus are provided based on available evidence from clinical trials and recommendations from the Neurocritical Care Society and the European Federation of Neurological Societies.
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Affiliation(s)
- M Pichler
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - S Hocker
- Division of Critical Care Neurology, Mayo Clinic, Rochester, MN, USA.
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22
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Lindenmann J, Fink-Neuboeck N, Avian A, Pichler M, Habitzruther M, Maier A, Smolle-Juettner FM. Preoperative Glasgow Prognostic Score as additional independent prognostic parameter for patients with esophageal cancer after curative esophagectomy. Eur J Surg Oncol 2016; 43:445-453. [PMID: 27839896 DOI: 10.1016/j.ejso.2016.10.015] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [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: 05/26/2016] [Revised: 08/21/2016] [Accepted: 10/13/2016] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Inflammation accelerates tumor growth followed by reduced survival in patients with cancer. The aim of this study was to evaluate the prognostic relevance of preoperatively increased levels of C-reactive protein (CRP) and the corresponding Glasgow Prognostic Score (GPS) on patients with esophageal carcinoma undergoing curative esophagectomy. METHODS The data of 174 operated esophageal cancer patients were evaluated retrospectively. Patient's demographic and clinico-pathological data, tumor specific data, preoperative plasma levels of CRP and albumin, the corresponding GPS, overall survival (OS) and progression free survival (PFS) were assessed. RESULTS 103 (59.2%) had adenocarcinoma and 71 (40.8%) had squamous cell carcinoma. 71 patients (43%) had elevated CRP concentrations. 118 patients (71%) had GPS 0, 41 (25%) GPS 1 and 8 (4%) GPS 2. Mean GPS was 0.3 (0-2). 5-year OS was higher in patients with normal CRP than in those with increased CRP (68% vs. 39%; p = 0.007). 5-year OS in patients with GPS 0 and GPS 1 and 2 were 65% and 31% (p = 0.001). 5-year OS for the whole cohort was 56% (1 year: 83%, 3 years: 64%). Recurrence rate was 16.1% closely associated with GPS (p = 0.002). Median follow-up was 23 months (0-118 months). In multivariate analysis GPS, lymph node involvement, T stage and tumor histology were the independent prognostic parameters (p = 0.004, <0.001, 0.035, 0.010). CONCLUSIONS Preoperatively increased GPS is significantly associated with reduced postoperative survival and tumor recurrence. The GPS as an independent prognosticator should be interpreted together with the TNM stage when the further postoperative treatment has to be scheduled.
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Affiliation(s)
- J Lindenmann
- Division of Thoracic and Hyperbaric Surgery, Department of Surgery, Medical University of Graz, Austria.
| | - N Fink-Neuboeck
- Division of Thoracic and Hyperbaric Surgery, Department of Surgery, Medical University of Graz, Austria
| | - A Avian
- Institute of Medical Informatics, Statistics and Documentation, Medical University of Graz, Austria
| | - M Pichler
- Division of Oncology, Department of Internal Medicine, Medical University of Graz, Austria
| | - M Habitzruther
- Department of Cell Stress Biology, Photodynamic Therapy Center at the Roswell Park Cancer Institute, University at Buffalo-State University of New York, Buffalo, USA
| | - A Maier
- Division of Thoracic and Hyperbaric Surgery, Department of Surgery, Medical University of Graz, Austria
| | - F M Smolle-Juettner
- Division of Thoracic and Hyperbaric Surgery, Department of Surgery, Medical University of Graz, Austria
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23
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Krska R, de Nijs M, McNerney O, Pichler M, Gilbert J, Edwards S, Suman M, Magan N, Rossi V, van der Fels-Klerx H, Bagi F, Poschmaier B, Sulyok M, Berthiller F, van Egmond H. Safe food and feed through an integrated toolbox for mycotoxin management: the MyToolBox approach. WORLD MYCOTOXIN J 2016. [DOI: 10.3920/wmj2016.2136] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
There is a pressing need to mobilise the wealth of knowledge from the international mycotoxin research conductedover the past 25-30 years, and to perform cutting-edge research where knowledge gaps still exist. This knowledgeneeds to be integrated into affordable and practical tools for farmers and food processors along the chain inorder to reduce the risk of mycotoxin contamination of crops, feed and food. This is the mission of MyToolBox – a four-year project which has received funding from the European Commission. It mobilises a multi-actorpartnership (academia, farmers, technology small and medium sized enterprises, food industry and policystakeholders) to develop novel interventions aimed at achieving a significant reduction in crop losses due tomycotoxin contamination. Besides a field-to-fork approach, MyToolBox also considers safe use options ofcontaminated batches, such as the efficient production of biofuels. Compared to previous efforts of mycotoxin reduction strategies, the distinguishing feature of MyToolBox is to provide the recommended measures to theend users along the food and feed chain in a web-based MyToolBox platform (e-toolbox). The project focuseson small grain cereals, maize, peanuts and dried figs, applicable to agricultural conditions in the EU and China. Crop losses using existing practices are being compared with crop losses after novel pre-harvest interventionsincluding investigation of genetic resistance to fungal infection, cultural control (e.g. minimum tillage or cropdebris treatment), the use of novel biopesticides suitable for organic farming, competitive biocontrol treatment and development of novel modelling approaches to predict mycotoxin contamination. Research into post-harvestmeasures includes real-time monitoring during storage, innovative sorting of crops using vision-technology, novelmilling technology and studying the effects of baking on mycotoxins at an industrial scale.
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Affiliation(s)
- R. Krska
- University of Natural Resources and Life Sciences, Vienna (BOKU), Department of Agrobiotechnology (IFA-Tulln), Center for Analytical Chemistry, Konrad-Lorenz-Str. 20, 3430 Tulln, Austria
| | - M. de Nijs
- RIKILT Wageningen University & Research, Akkermaalsbos 2, 6708 WB Wageningen, the Netherlands
| | - O. McNerney
- Innovacio i Recerca Industrial i Sostenible SL, Avda. Carl Friedrich Gauss 11, 08860 Castelldefels, Spain
| | - M. Pichler
- International Association for Cereal Science and Technology, Marxergasse 2, 1030 Vienna, Austria
| | - J. Gilbert
- FoodLife International Ltd., ODTU Teknokent, Ikizler Binasi No Ara-1 ODTU, Cankaya 06800, Turkey
| | - S. Edwards
- Harper Adams University, Department of Crop and Environment Science, Edgmond, Newport, Shropshire TF10 8NB, United Kingdom
| | - M. Suman
- BARILLA S.p.A., Advanced Laboratory Research, Barilla Research Labs, via Mantova 166, 43122 Parma, Italy
| | - N. Magan
- Cranfield University, Applied Mycology Group, Soil and Agrifood Institute, Cranfield Health, Cranfield, Bedford MK43 0AL, United Kingdom
| | - V. Rossi
- HORTA SRL, via E. Gorra, 29122 Piacenza, Italy
| | - H.J. van der Fels-Klerx
- RIKILT Wageningen University & Research, Akkermaalsbos 2, 6708 WB Wageningen, the Netherlands
| | - F. Bagi
- University of Novi Sad, Faculty of Agriculture, Trg Dositeja Obradovića 8, Novi Sad 21000, Serbia
| | - B. Poschmaier
- University of Natural Resources and Life Sciences, Vienna (BOKU), Department of Agrobiotechnology (IFA-Tulln), Center for Analytical Chemistry, Konrad-Lorenz-Str. 20, 3430 Tulln, Austria
| | - M. Sulyok
- University of Natural Resources and Life Sciences, Vienna (BOKU), Department of Agrobiotechnology (IFA-Tulln), Center for Analytical Chemistry, Konrad-Lorenz-Str. 20, 3430 Tulln, Austria
| | - F. Berthiller
- University of Natural Resources and Life Sciences, Vienna (BOKU), Department of Agrobiotechnology (IFA-Tulln), Center for Analytical Chemistry, Konrad-Lorenz-Str. 20, 3430 Tulln, Austria
| | - H.P. van Egmond
- Retired from RIKILT, Wageningen University & Research, the Netherlands
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24
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Winder T, Posch F, Asamer E, Stotz M, Siebenhüner A, Schlick K, Magnes T, Samaras P, Szkandera J, Clavien PA, Neureiter D, Greil R, Pestalozzi B, Stoeger H, Gerger A, Egle A, Pichler M. An elevated fibrinogen/CRP ratio predicts a remarkable survival advantage in patients with metastatic pancreatic cancer. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw371.77] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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25
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Riedl J, Posch F, Stotz M, Bezan A, Winder T, Schaberl-Moser R, Pichler M, Stoeger H, Gerger A. Patterns of venous thromboembolism risk in patients with localized colorectal cancer undergoing adjuvant chemotherapy or active surveillance. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw370.107] [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: 11/12/2022] Open
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26
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Bonin S, Donada M, Bussolati G, Nardon E, Pichler M, Chiaravalli A, Capella C, Annaratone L, Hoefler G, Stanta G. The EGFR synonymous polymorphism rs1050171 predicts responsiveness to anti-EGFR therapy in metastatic colorectal cancer patients. Eur J Cancer 2016. [DOI: 10.1016/s0959-8049(16)61643-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: 10/21/2022]
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27
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Pichler M, Thuile T, Gatscher B, Tappeiner L, Deluca J, Larcher L, Holzer M, Nguyen V, Exler G, Schmuth M, Klein G, Eisendle K. Systematic review of surgical treatment of pyoderma gangrenosum with negative pressure wound therapy or skin grafting. J Eur Acad Dermatol Venereol 2016; 31:e61-e67. [DOI: 10.1111/jdv.13727] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- M. Pichler
- Department of Dermatology, Venereology and Allergology; Academic Teaching Department of Medical University Innsbruck; Central Teaching Hospital Bolzano/Bozen; Bolzano/Bozen Italy
| | - T. Thuile
- Department of Dermatology, Venereology and Allergology; Academic Teaching Department of Medical University Innsbruck; Central Teaching Hospital Bolzano/Bozen; Bolzano/Bozen Italy
| | - B. Gatscher
- Department of Dermatology, Venereology and Allergology; Academic Teaching Department of Medical University Innsbruck; Central Teaching Hospital Bolzano/Bozen; Bolzano/Bozen Italy
| | - L. Tappeiner
- Department of Dermatology, Venereology and Allergology; Academic Teaching Department of Medical University Innsbruck; Central Teaching Hospital Bolzano/Bozen; Bolzano/Bozen Italy
| | - J. Deluca
- Department of Dermatology, Venereology and Allergology; Academic Teaching Department of Medical University Innsbruck; Central Teaching Hospital Bolzano/Bozen; Bolzano/Bozen Italy
| | - L. Larcher
- Department of Plastic, Aesthetic and Reconstructive Surgery; Hospital of St. John of God Salzburg; Paracelsus Medical University Salzburg; Salzburg Austria
| | - M. Holzer
- University Department of Dermatology and Venereology; Medical University Innsbruck; Innsbruck Austria
| | - V.A. Nguyen
- University Department of Dermatology and Venereology; Medical University Innsbruck; Innsbruck Austria
| | - G. Exler
- Department of Dermatology; Hospital of Elisabethinen; Linz Austria
| | - M. Schmuth
- University Department of Dermatology and Venereology; Medical University Innsbruck; Innsbruck Austria
| | - G.F. Klein
- Department of Dermatology; Hospital of Elisabethinen; Linz Austria
| | - K. Eisendle
- Department of Dermatology, Venereology and Allergology; Academic Teaching Department of Medical University Innsbruck; Central Teaching Hospital Bolzano/Bozen; Bolzano/Bozen Italy
- College of Health Care Professions; Bolzano/Bozen Italy
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28
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Pichler M, Calin GA. MicroRNAs in cancer: from developmental genes in worms to their clinical application in patients. Br J Cancer 2015; 113:569-73. [PMID: 26158421 PMCID: PMC4647691 DOI: 10.1038/bjc.2015.253] [Citation(s) in RCA: 158] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Revised: 06/03/2015] [Accepted: 06/07/2015] [Indexed: 12/21/2022] Open
Abstract
Several discoveries have paved the way to personalise cancer medicine and a tremendous gain of
knowledge in genomics and molecular mechanisms of cancer progression cumulated over the last years.
Big stories in biology commonly start in a simple model system. No wonder microRNAs have been
identified as regulators of embryonic development in the nematode Caenorhabditis elegans.
From the first identification in worms to the first-in-man microRNA-based clinical trial in humans,
almost 20 years passed. In this review we follow the story of understanding microRNA alterations in
cancer, describe recent developments in the microRNA field and critically discuss their potential as
diagnostic, prognostic and therapeutics factors in cancer medicine. We will explain the rationale
behind the use of microRNAs in cancer diagnosis and prognosis prediction, but also discuss the
limitations and pitfalls associated with this. Novel developments of combined microRNA/siRNA
pharmacological approaches will be discussed and most recently data about MXR34, the first-tested
microRNA drug will be described.
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Affiliation(s)
- M Pichler
- 1] Department of Experimental Therapeutics, The University of Texas, MD Anderson Cancer Center, Houston, TX, USA [2] Division of Oncology, Medical University of Graz, Austria
| | - G A Calin
- 1] Department of Experimental Therapeutics, The University of Texas, MD Anderson Cancer Center, Houston, TX, USA [2] The Center for RNA Interference and Non-coding RNAs, The University of Texas, MD Anderson Cancer Center, Houston, TX, USA
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Pichler M, Novacek J, Robiette R, Poscher V, Himmelsbach M, Monkowius U, Müller N, Waser M. Asymmetric syntheses of three-membered heterocycles using chiral amide-based ammonium ylides. Org Biomol Chem 2015; 13:2092-9. [PMID: 25521410 PMCID: PMC4323751 DOI: 10.1039/c4ob02318h] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Phenylglycinol serves as a powerful chiral auxiliary in ammonium ylide-mediated reactions to obtain chiral epoxides/aziridines with excellent stereoselectivities.
The use of carbonyl-stabilised ammonium ylides to access chiral glycidic amides and the corresponding aziridines has so far been limited to racemic trans-selective protocols. We herein report the development of an asymmetric approach to access such compounds with high levels of stereoselectivity using easily accessible chiral auxiliary-based ammonium ylides. The use of phenylglycinol as the chiral auxiliary was found to be superior to Evans or pseudoephedrine-based auxiliaries resulting in good to excellent stereoselectivities in both, epoxidation and aziridination reactions.
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Affiliation(s)
- Mathias Pichler
- Institute of Organic Chemistry, Johannes Kepler University Linz, Altenbergerstraße 69, 4040 Linz, Austria.
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Stiegelbauer V, Ress A, Schwarzenbacher D, Deutsch A, Perakis S, Ling H, Ivan C, Calin G, Gerger A, Rinner B, Pichler M. P-219 The role of the putative tumor suppressor protein spinophilin in colorectal cancer. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv233.216] [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: 11/13/2022] Open
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Schwarzenbacher D, Stiegelbauer V, Deutsch A, Ress A, Aigelsreiter A, Schauer S, Gerger A, Höfler G, Rinner B, Pichler M. Low spinophilin expression is associated with poor prognosis and cellular growth in human breast cancer. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv120.06] [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: 11/14/2022] Open
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Krenn-Pilko S, Langsenlehner U, Thurner E, Stojakovic T, Pichler M, Gerger A, Kapp K, Langsenlehner T. PO-0682: External validation of the derived neutrophil-tolymphocyte ratio as a prognostic factor in breast cancer patients. Radiother Oncol 2015. [DOI: 10.1016/s0167-8140(15)40674-7] [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]
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Strobel D, Bernatik T, Blank W, Will U, Reichel A, Wüstner M, Keim V, Schacherer D, Barreiros AP, Kunze G, Nürnberg D, Ignee A, Burmester E, Bunk AA, Friedrich-Rust M, Froehlich E, Schuler A, Jenssen C, Bohle W, Mauch M, Dirks K, Kaemmer J, Pachmann C, Stock J, Hocke M, Kendel A, Schmidt C, Jakobeit C, Kinkel H, Heinz W, Hübner G, Pichler M, Müller T. Incidence of bleeding in 8172 percutaneous ultrasound-guided intraabdominal diagnostic and therapeutic interventions - results of the prospective multicenter DEGUM interventional ultrasound study (PIUS study). Ultraschall Med 2015; 36:122-131. [PMID: 25876060 DOI: 10.1055/s-0034-1399282] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
PURPOSE To analyse the incidence of bleeding after percutaneous ultrasound guided diagnostic and therapeutic intraabdominal interventions in a prospective multicentre study (DEGUM percutaneous interventional ultrasound study). MATERIALS AND METHODS Within a time period of 2 years diagnostic and therapeutic intraabdominal interventions (with the exclusion of ascites paracentesis) performed percutaneously under continuous ultrasound (US) guidance were prospectively assessed using a pseudonymized standardized web site entry form. Number and type of intervention, operator experience, patient characteristics, medication, lab data as well as technical aspects of the procedure and bleeding complications were analysed according to the interventional radiology standards. RESULTS 8172 US-guided intraabdominal interventions (liver n = 5903; pancreas n = 501, kidney n = 434, lymph node = 272, biliary system n = 153, spleen n = 63, other abdominal organs and extra-organic targets n = 999) were analysed in 30 hospitals. The majority were diagnostic biopsies including 1780 liver parenchyma, 3400 focal liver lesions and 404 pancreatic lesions. 7525 interventions (92.1 %) were performed in hospitalized patients (mean age 62.6 years). Most operators were highly experienced in US-guided interventions (> 500 interventions prior to the study n = 5729; 70.1 %). Sedation was administered in 1131 patients (13.8 %). Needle diameter was ≥ 1 mm in 7162 punctures (87.9 %) with main focus on core needle biopsies (18 G, n = 4185). Clinically relevant bleeding complications with need of transfusion (0.4 %), surgical bleeding control (0.1 %) and radiological coiling (0.05 %) were very rare. Bleeding complications with fatal outcome occurred in four patients (0.05 %). The frequency of major bleeding complications was significantly higher in patients with an INR > 1.5 (p < 0.001) and patients taking a medication potentially interfering with platelet function or plasmatic coagulation (p < 0.0333). CONCLUSION This prospective multicentre study confirms the broad spectrum of percutaneous US-guided intraabdominal interventions. However diagnostic liver biopsies dominate with the use of core needle biopsies (18 G). Percutaneous US-guided interventions performed by experienced sonographers are associated with a low bleeding risk. Major bleeding complications are very rare. A pre-interventional INR < 1.5 and individual medication risk assessment are recommended.
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Affiliation(s)
- D Strobel
- Internal Medicine 1, University Hospital Erlangen, Germany
| | - T Bernatik
- Department of Internal Medicine, District Hospital Ebersberg, Germany
| | - W Blank
- Department of Internal Medicine 1, Municipal Hospital Steinenberg, Reutlingen, Germany
| | - U Will
- Department of Gastroenterology, Municipal Hospital (Waldklinikum Gera gGmbH), Gera, Germany
| | - A Reichel
- Department of Gastroenterology, Municipal Hospital (Waldklinikum Gera gGmbH), Gera, Germany
| | - M Wüstner
- Central Interdisciplinary Ultrasound, Municipal Hospital Trier (Barmherzige Brüder), Trier, Germany
| | - V Keim
- Department of Gastroenterology, Central Ultrasound Unit, University Hospital Leipzig, Germany
| | - D Schacherer
- Department of Internal Medicine 1, University Hospital Regensburg, Germany
| | - A P Barreiros
- Department of Internal Medicine 1, University Hospital Mainz, Germany
| | - G Kunze
- Department of Internal Medicine 1, Municipal Hospital (Schwarzwald-Baar), Villingen-Schwenningen, Germany
| | - D Nürnberg
- Department of Internal Medicine B, Gastroenterology, District Hospital (Ruppiner Kliniken), Neuruppin, Germany
| | - A Ignee
- Department of Internal Medicine 2, Municipal Hospital (Caritas), Bad Mergentheim, Germany
| | - E Burmester
- Department of Internal Medicine/Gastroenterology, Municipal Hospital (Sana Kliniken Lübeck GmbH), Lübeck, Germany
| | - A A Bunk
- Surgery, University Hospital Dresden, Germany
| | - M Friedrich-Rust
- Department of Internal Medicine 1, University Hospital Frankfurt, Germany
| | - E Froehlich
- Department of Internal Medicine 1, Municipal Hospital (Karl-Olga-Krankenhaus), Stuttgart, Germany
| | - A Schuler
- Department of Internal Medicine, District Hospital Helfenstein, Geislingen, Germany
| | - C Jenssen
- Department of Internal Medicine, District Hospital (Krankenhaus Märkisch Oderland GmbH), Wriezen, Germany
| | - W Bohle
- Department of Medicine and Gastroenterology, Municipal Hospital (Katharinen), Stuttgart, Germany
| | - M Mauch
- Innere Medicine, District Hospital (SRH Kliniken Sigmaringen), Sigmaringen, Germany
| | - K Dirks
- Department of Interal Medicine and Gastroenterology, District Hospital Rems-Murr, Winnenden, Germany
| | - J Kaemmer
- Depatment of Internal Medicine, Hospital St Hedwig, Berlin, Germany
| | - C Pachmann
- Department of Internal Medicine, Israeli Hospital, Hamburg, Germany
| | - J Stock
- Gastroenterology, Hospital Vivantes Humboldt, Berlin, Germany
| | - M Hocke
- Department of Medicine 2 and Gastroenterology, District Hospital Helios Meiningen, Germany
| | - A Kendel
- Department of Internal Medicine, District Hospital Gummersbach, Germany
| | - C Schmidt
- Department of Internal Medicine, Hospital Albertinen, Hamburg, Germany
| | - C Jakobeit
- Gastroenterology, St. Josefs Hospital (Helios), Bochum, Germany
| | - H Kinkel
- Department of Internal Medicine 2, Municipal Hosital Düren, Germany
| | - W Heinz
- Department of Internal Medicine, Hospital Leonberg, Germany
| | - G Hübner
- Department of Internal Medicine, District Hospital Köthen, Germany
| | - M Pichler
- Campus Innenstadt Gastroenterology, University Hospital Munich, Germany
| | - T Müller
- Department of Internal Medicine 1, Municipal Hospital Steinenberg, Reutlingen, Germany
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Krenn-Pilko S, Langsenlehner U, Thurner E, Stojakovic T, Pichler M, Gerger A, Kapp K, Langsenlehner T. P229 An elevated preoperative plasma fibrinogen level is related with poor prognosis in breast cancer. Breast 2015. [DOI: 10.1016/s0960-9776(15)70261-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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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Stemberger M, Seybold U, Eberle J, Denk G, Kolligs F, Kaspar M, Guba M, Pichler M, Spannagl M. Haemophilia-related outcome after liver transplantation and treatment with sofosbuvir/ribavirin in a HCV-HIV coinfected man with liver failure and hepatocellular carcinoma. Haemophilia 2015; 21:e131-e133. [PMID: 25622556 DOI: 10.1111/hae.12599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/31/2014] [Indexed: 11/26/2022]
Affiliation(s)
- M Stemberger
- Haemostaseologie, Medizinische Klinik und Poliklinik IV, Klinikum der LMU, Munich, Germany
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Ling H, Vincent K, Pichler M, Fodde R, Berindan-Neagoe I, Slack FJ, Calin GA. Junk DNA and the long non-coding RNA twist in cancer genetics. Oncogene 2015; 34:5003-11. [PMID: 25619839 PMCID: PMC4552604 DOI: 10.1038/onc.2014.456] [Citation(s) in RCA: 261] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2014] [Revised: 12/03/2014] [Accepted: 12/04/2014] [Indexed: 02/07/2023]
Abstract
The central dogma of molecular biology states that the flow of genetic information moves from DNA to RNA to protein. However, in the last decade this dogma has been challenged by new findings on non-coding RNAs (ncRNAs) such as microRNAs (miRNAs). More recently, long non-coding RNAs (lncRNAs) have attracted much attention due to their large number and biological significance. Many lncRNAs have been identified as mapping to regulatory elements including gene promoters and enhancers, ultraconserved regions, and intergenic regions of protein-coding genes. Yet, the biological function and molecular mechanisms of lncRNA in human diseases in general and cancer in particular remain largely unknown. Data from the literature suggest that lncRNA, often via interaction with proteins, functions in specific genomic loci or use their own transcription loci for regulatory activity. In this review, we summarize recent findings supporting the importance of DNA loci in lncRNA function, and the underlying molecular mechanisms via cis or trans regulation, and discuss their implications in cancer. In addition, we use the 8q24 genomic locus, a region containing interactive SNPs, DNA regulatory elements and lncRNAs, as an example to illustrate how single nucleotide polymorphism (SNP) located within lncRNAs may be functionally associated with the individual’s susceptibility to cancer.
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Affiliation(s)
- H Ling
- Department of Experimental Therapeutics, MD Anderson Cancer Center, University of Texas, Houston, TX, USA
| | - K Vincent
- Department of Experimental Therapeutics, MD Anderson Cancer Center, University of Texas, Houston, TX, USA
| | - M Pichler
- Department of Experimental Therapeutics, MD Anderson Cancer Center, University of Texas, Houston, TX, USA
| | - R Fodde
- Department of Pathology, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - I Berindan-Neagoe
- Department of Experimental Therapeutics, MD Anderson Cancer Center, University of Texas, Houston, TX, USA.,Department of Immunology and Research Center for Functional Genomics, Biomedicine and Translational Medicine University of Medicine and Pharmacy 'I. Hatieganu', Cluj-Napoca, Romania.,Department of Functional Genomics, The Oncology Institute Ion Chiricuta, Cluj-Napoca, Romania
| | - F J Slack
- Department of Pathology, Beth Israel Deaconess Medical Center, Harvard medical School, Boston, MA, USA
| | - G A Calin
- Department of Experimental Therapeutics, MD Anderson Cancer Center, University of Texas, Houston, TX, USA
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Gary T, Pichler M, Belaj K, Eller P, Hafner F, Gerger A, Brodmann M. Lymphocyte-to-monocyte ratio: a novel marker for critical limb ischemia in PAOD patients. Int J Clin Pract 2014; 68:1483-7. [PMID: 25359092 DOI: 10.1111/ijcp.12495] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2014] [Accepted: 06/13/2014] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The lymphocyte-to-monocyte ratio (LMR) is easily determined from the white blood cell count. Lymphocytes were previously investigated as a part of the neutrophil-to-lymphocyte ratio (NLR) in patients with atherosclerotic disease and an elevated NLR was negatively associated with cardiovascular endpoints. As monocytes play a leading role in the progression of atherosclerosis, especially in peripheral arterial occlusive disease (PAOD), we investigated LMR and its association with critical limb ischemia and other vascular endpoints in PAOD patients. METHODS AND FINDINGS We evaluated 2121 PAOD patients treated at our institution from 2005 to 2010. LMR was calculated and the cohort was divided into tertiles according to the LMR. An optimal cut-off value for the continuous LMR was calculated by applying a receiver operating curve analysis to discriminate between CLI and non-CLI. In our cohort occurrence of CLI decreased significantly with an increase in LMR. An LMR of 3.1 was identified as an optimal cut-off. Two groups were categorized, one with 1021 patients (LMR < 3.1) and a second one with 1100 patients (LMR ≥ 3.1). CLI was more frequent in LMR < 3.1 patients [426 (41.7%)] than in LMR ≥ 3.1 patients [254 (23.1%)] (p < 0.001), as was also the case with prior myocardial infarction [60 (9.5%) vs. 35 (3.2%), p = 0.003] and congestive heart failure [136 (13.3%) vs. 66 (6.0%), p < 0.001). As to inflammatory parameters, C-reactive protein [median 9.0 mg/l (4.0-30.0) vs. median 4.0 mg/l (2.0-8.0)] and fibrinogen (median 438 mg/dl (350-563) vs. 372 mg/dl (316-459.5)] also differed significantly in the two patient groups (both p < 0.001). A LMR < 3.1 was associated with an odds ratio (OR) of 2.0 (95% CI 1.8-2.2, p < 0.001) for CLI, even after adjustment for other vascular risk factors. CONCLUSIONS A decreased LMR is significantly associated with a high risk for CLI and other vascular endpoints. The LMR is an easily determinable, broadly available and inexpensive marker that could be used to identify patients at high risk for vascular endpoints.
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Affiliation(s)
- T Gary
- Division of Vascular Medicine, Department of Internal Medicine, Medical University of Graz, Graz, Austria
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Pichler M, Damberger A, Arnholdt T, Schwendenwein I, Gasteiner J, Drillich M, Iwersen M. Evaluation of 2 electronic handheld devices for diagnosis of ketonemia and glycemia in dairy goats. J Dairy Sci 2014; 97:7538-46. [PMID: 25282414 DOI: 10.3168/jds.2014-8198] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [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: 04/02/2014] [Accepted: 08/15/2014] [Indexed: 11/19/2022]
Abstract
The objective of this study was to evaluate the suitability of the electronic handheld devices FreeStyle Precision (FSP; Abbott Germany, Wiesbaden, Germany) and GlucoMen LX Plus (GML; A. Menarini GmbH, Vienna, Austria) for the measurement of β-hydroxybutyrate (BHBA) in whole blood in dairy goats. Additionally, glucose concentration was analyzed with the FSP device. For method comparison, the samples were also analyzed in the laboratory by standard methods, which served as the gold standard in our study. A further objective was to evaluate the agreement between samples obtained by minimal invasive venipuncture of an ear vein and measurements of whole blood samples from the jugular vein (vena jugularis). In total, 173 blood sample pairs collected from 28 goats were obtained from an ear vein and from the jugular vein. The Spearman correlation coefficients (rsp) for BHBA concentrations determined with the FSP or GML and the gold standard were 0.95 and 0.85 for the ear vein and 0.98 and 0.88 for the jugular vein, respectively. Bland-Altman plots of differences showed a positive bias of 0.12 (ear vein) and 0.21 (jugular vein) when determination was performed with the FSP and a negative bias of 0.21 (ear vein) and 0.24 (jugular vein) when using the GML. For the FSP, applying the adjusted thresholds determined by ROC analysis of 0.9 (ear vein) and 1.0 mmol/L (jugular vein) allowed to distinguish between healthy goats and animals with hyperketonemia with sensitivities (Se) and specificities (Sp) for samples from the ear vein of 0.98 and 0.85, and from the jugular vein of 0.99 and 0.94, respectively. For the GML, adjusted thresholds were 0.5 mmol/L for the ear vein (Se=0.94, Sp=0.75) and 0.6 mmol/L for the jugular vein (Se=0.88, Sp=0.91). Repeated analyses of defined whole blood samples showed average inter- and intraassay coefficients of variation of 6.6 and 7.3% for FSP, and of 35.6 and 35.4% for GML, respectively. Test characteristics for determining glucose concentration with the FSP compared with the gold standard were poor (ear vein: rsp=0.41; jugular vein: rsp=0.51), with low validity to distinguish between hypo- and normoglycemia (Se=0.71, Sp=0.66). The present study showed good test characteristics for the FSP and moderate for the GML device for determining BHBA concentrations in whole blood. Additionally the results demonstrate the suitability of testing BHBA concentration in a blood drop obtained from an ear vein. Based on the results of this study, the FSP device is not suitable to differentiate normo- from hypoglycemia in goats.
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Affiliation(s)
- M Pichler
- University Clinic for Ruminants, Clinical Unit for Herd Health Management in Ruminants, Department for Farm Animals and Veterinary Public Health, University of Veterinary Medicine Vienna, 1210 Vienna, Austria
| | - A Damberger
- University Clinic for Ruminants, Clinical Unit for Herd Health Management in Ruminants, Department for Farm Animals and Veterinary Public Health, University of Veterinary Medicine Vienna, 1210 Vienna, Austria
| | - T Arnholdt
- University Clinic for Ruminants, Clinical Unit for Herd Health Management in Ruminants, Department for Farm Animals and Veterinary Public Health, University of Veterinary Medicine Vienna, 1210 Vienna, Austria
| | - I Schwendenwein
- Central Clinical Pathology Unit, Department for Pathobiology, University of Veterinary Medicine Vienna, 1210 Vienna, Austria
| | - J Gasteiner
- Agricultural Research and Education Center Raumberg-Gumpenstein, 8952 Irdning, Styria, Austria
| | - M Drillich
- University Clinic for Ruminants, Clinical Unit for Herd Health Management in Ruminants, Department for Farm Animals and Veterinary Public Health, University of Veterinary Medicine Vienna, 1210 Vienna, Austria
| | - M Iwersen
- University Clinic for Ruminants, Clinical Unit for Herd Health Management in Ruminants, Department for Farm Animals and Veterinary Public Health, University of Veterinary Medicine Vienna, 1210 Vienna, Austria.
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Pichler M, Staffler A, Bonometti N, Messner H, Deluca J, Thuile T, Kluge R, Schmuth M, Eisendle K. Premature newborns with fatal intrauterine herpes simplex virus-1 infection: first report of twins and review of the literature. J Eur Acad Dermatol Venereol 2014; 29:1216-20. [DOI: 10.1111/jdv.12583] [Citation(s) in RCA: 64] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2014] [Accepted: 05/12/2014] [Indexed: 11/30/2022]
Affiliation(s)
- M. Pichler
- Department of Dermatology, Venereology and Allergology; Academic Teaching Department of Innsbruck Medical University; Central Teaching Hospital of Bolzano/Bozen; Bolzano/Bozen Italy
| | - A. Staffler
- Neonatal Intensive Care Unit; Central Teaching Hospital of Bolzano/Bozen; Bolzano Italy
| | - N. Bonometti
- Department of Dermatology, Venereology and Allergology; Academic Teaching Department of Innsbruck Medical University; Central Teaching Hospital of Bolzano/Bozen; Bolzano/Bozen Italy
| | - H. Messner
- Neonatal Intensive Care Unit; Central Teaching Hospital of Bolzano/Bozen; Bolzano Italy
| | - J. Deluca
- Department of Dermatology, Venereology and Allergology; Academic Teaching Department of Innsbruck Medical University; Central Teaching Hospital of Bolzano/Bozen; Bolzano/Bozen Italy
| | - T. Thuile
- Department of Dermatology, Venereology and Allergology; Academic Teaching Department of Innsbruck Medical University; Central Teaching Hospital of Bolzano/Bozen; Bolzano/Bozen Italy
| | - R. Kluge
- Department of Pathology; Central Teaching Hospital of Bolzano/Bozen; Bolzano Italy
| | - M. Schmuth
- Department of Dermatology; Innsbruck Medical University; Innsbruck Austria
| | - K. Eisendle
- Department of Dermatology, Venereology and Allergology; Academic Teaching Department of Innsbruck Medical University; Central Teaching Hospital of Bolzano/Bozen; Bolzano/Bozen Italy
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Krenn-Pilko S, Langsenlehner U, Thurner EM, Stojakovic T, Pichler M, Gerger A, Kapp KS, Langsenlehner T. The elevated preoperative platelet-to-lymphocyte ratio predicts poor prognosis in breast cancer patients. Br J Cancer 2014; 110:2524-30. [PMID: 24675383 PMCID: PMC4021515 DOI: 10.1038/bjc.2014.163] [Citation(s) in RCA: 207] [Impact Index Per Article: 20.7] [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] [Revised: 02/01/2014] [Accepted: 03/04/2014] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND The elevation of the platelet-to-lymphocyte ratio (PLR), an easily applicable blood test based on platelet and lymphocyte counts has been associated with poor prognosis in patients with different types of cancer. The present study was aimed to investigate the prognostic significance of the preoperative PLR in a large cohort of breast cancer patients. METHODS Data from 793 consecutive non-metastatic breast cancer patients, treated between 1999 and 2004, were evaluated retrospectively. The optimal cutoff values for the PLR were calculated using receiver operating curve analysis. Cancer-specific survival (CSS), overall survival (OS) as well as distant metastasis-free survival (DMFS) were assessed using the Kaplan-Meier method. To evaluate the independent prognostic significance of PLR, multivariable Cox regression models were applied for all three different end points. RESULTS Univariable analysis revealed a significant association between the elevated preoperative PLR and CSS (hazard ratio (HR): 2.75, 95% confidence interval (CI): 1.57-4.83, P<0.001) that remained statistically significant in multivariable analysis (HR: 2.03, 95% CI: 1.03-4.02, P=0.042). An increased PLR was also significantly associated with decreased OS in univariable (HR: 2.45, 95% CI: 1.43-4.20, P=0.001) and in multivariable analysis (HR: 1.92, 95% CI: 1.01-3.67, P=0.047). Furthermore, univariable analysis showed a significant impact of increased PLR on DMFS (HR: 2.02, 95% CI: 1.18-3.44, P=0.010). Subgroup analysis revealed significant associations of the elevated PLR on the primary end point CSS for all breast cancer subtypes. This association retained its significance in multivariable analysis in patients with luminal B tumours (HR: 2.538, 95% CI: 1.043-6.177, P=0.040). CONCLUSIONS In this study, we identified the preoperative PLR as an independent prognostic marker for survival in breast cancer patients. Independent validation of our findings is needed.
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Affiliation(s)
- S Krenn-Pilko
- Department of Therapeutic Radiology and Oncology, Medical University of Graz, Auenbruggerplatz 32, 8036 Graz, Austria
| | - U Langsenlehner
- Division of Internal Medicine, Outpatient Department Graz, Graz, Austria
| | - E-M Thurner
- Department of Therapeutic Radiology and Oncology, Medical University of Graz, Auenbruggerplatz 32, 8036 Graz, Austria
| | - T Stojakovic
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
| | - M Pichler
- Department of Experimental Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - A Gerger
- Division of Clinical Oncology, Department of Medicine, Medical University of Graz, Graz, Austria
| | - K S Kapp
- Department of Therapeutic Radiology and Oncology, Medical University of Graz, Auenbruggerplatz 32, 8036 Graz, Austria
| | - T Langsenlehner
- Department of Therapeutic Radiology and Oncology, Medical University of Graz, Auenbruggerplatz 32, 8036 Graz, Austria
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Dalpiaz O, Pichler M, Mannweiler S, Martín Hernández JM, Stojakovic T, Pummer K, Zigeuner R, Hutterer GC. Validation of the pretreatment derived neutrophil-lymphocyte ratio as a prognostic factor in a European cohort of patients with upper tract urothelial carcinoma. Br J Cancer 2014; 110:2531-6. [PMID: 24691424 PMCID: PMC4021523 DOI: 10.1038/bjc.2014.180] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.8] [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: 02/17/2014] [Revised: 03/08/2014] [Accepted: 03/11/2014] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND The value of a combined index of neutrophil and white cell counts, named derived neutrophil-lymphocyte ratio (dNLR), has recently been proposed as a prognosticator of survival in various cancer types. We investigated the prognostic role of the dNLR in a large European cohort of patients with upper tract urothelial carcinoma (UTUC). METHODS Data from 171 non-metastatic UTUC patients, operated between 1990 and 2012 at a single tertiary academic centre, were evaluated retrospectively. Cancer-specific- (CSS) as well as overall survival (OS) were assessed using the Kaplan-Meier method. To evaluate the independent prognostic significance of the dNLR, multivariate proportional Cox-regression models were applied. Additionally, the influence of the dNLR on the predictive accuracy of the multivariate model was further determined by Harrell's concordance index (c-index). RESULTS The median follow-up period was 31 months. An increased dNLR was statistically significantly associated with shorter CSS (log-rank P=0.004), as well as with shorter OS (log-rank P=0.002). Multivariate analysis identified dNLR as an independent predictor for CSS (hazard ratio, HR=1.16, 95% confidence interval, CI=1.01-1.35, P=0.045), as well as for OS (HR=1.21, 95% CI=1.09-1.34, P<0.001). The estimated c-index of the multivariate model for OS was 0.68 without dNLR and 0.73 when dNLR was added. CONCLUSIONS Patients with a high pretreatment dNLR could be predicted to show subsequently higher cancer-specific- as well as overall mortality after surgery for UTUC compared with those with a low pretreatment dNLR. Thus, this combined index should be considered as a potential prognostic biomarker in future.
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Affiliation(s)
- O Dalpiaz
- Department of Urology, Medical University of Graz, Auenbruggerplatz 5/6, A-8036 Graz, Austria
| | - M Pichler
- Division of Oncology, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, A-8036 Graz, Austria
- Department of Experimental Therapeutics, The University of Texas MD Anderson Cancer Center, 1901 East Road, Houston, TX 77054, USA
| | - S Mannweiler
- Institute of Pathology, Medical University of Graz, Auenbruggerplatz 25, A-8036 Graz, Austria
| | - J M Martín Hernández
- Department of Urology, Medical University of Graz, Auenbruggerplatz 5/6, A-8036 Graz, Austria
| | - T Stojakovic
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Auenbruggerplatz 15, A-8036 Graz, Austria
| | - K Pummer
- Department of Urology, Medical University of Graz, Auenbruggerplatz 5/6, A-8036 Graz, Austria
| | - R Zigeuner
- Department of Urology, Medical University of Graz, Auenbruggerplatz 5/6, A-8036 Graz, Austria
| | - G C Hutterer
- Department of Urology, Medical University of Graz, Auenbruggerplatz 5/6, A-8036 Graz, Austria
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Deluca J, Gatscher B, Tappeiner L, Pichler M, Eisendle K. Direct comparison between negative wound pressure therapy and negatively charged polystyrene microspheres in wound bed preparation for split skin grafting in two large symmetric whole circumference leg ulcers, a single patient experience. J Eur Acad Dermatol Venereol 2014; 29:1649-51. [DOI: 10.1111/jdv.12527] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2014] [Accepted: 03/17/2014] [Indexed: 11/30/2022]
Affiliation(s)
- J. Deluca
- Department of Dermatology; Venerology and Allergology; Academic Teaching Department of Innsbruck Medical University; Central Teaching Hospital of Bolzano; Bozen Italy
| | - B. Gatscher
- Department of Dermatology; Venerology and Allergology; Academic Teaching Department of Innsbruck Medical University; Central Teaching Hospital of Bolzano; Bozen Italy
| | - L. Tappeiner
- Department of Dermatology; Venerology and Allergology; Academic Teaching Department of Innsbruck Medical University; Central Teaching Hospital of Bolzano; Bozen Italy
| | - M. Pichler
- Department of Dermatology; Venerology and Allergology; Academic Teaching Department of Innsbruck Medical University; Central Teaching Hospital of Bolzano; Bozen Italy
| | - K. Eisendle
- Department of Dermatology; Venerology and Allergology; Academic Teaching Department of Innsbruck Medical University; Central Teaching Hospital of Bolzano; Bozen Italy
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Pichler M, Damberger A, Schwendenwein I, Gasteiner J, Drillich M, Iwersen M. Thresholds of whole-blood β-hydroxybutyrate and glucose concentrations measured with an electronic hand-held device to identify ovine hyperketonemia. J Dairy Sci 2014; 97:1388-99. [DOI: 10.3168/jds.2013-7169] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2013] [Accepted: 11/16/2013] [Indexed: 11/19/2022]
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Stotz M, Pichler M, Absenger G, Szkandera J, Arminger F, Schaberl-Moser R, Samonigg H, Stojakovic T, Gerger A. The preoperative lymphocyte to monocyte ratio predicts clinical outcome in patients with stage III colon cancer. Br J Cancer 2014; 110:435-40. [PMID: 24357796 PMCID: PMC3899781 DOI: 10.1038/bjc.2013.785] [Citation(s) in RCA: 247] [Impact Index Per Article: 24.7] [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: 07/24/2013] [Revised: 11/04/2013] [Accepted: 11/19/2013] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Inflammation has a critical role in the pathogenesis and progression of cancer. The lymphocyte to monocyte ratio (LMR) could be shown to be prognostic in haematologic neoplasia. In this study, we analysed the LMR with clinical outcome in stage II and III colon cancer patients. METHODS Three hundred and seventy-two patients with stage II and III colon cancer were included in this retrospective study. Kaplan-Meier curves and multivariate Cox-regression analyses were calculated for time to recurrence (TTR) and overall survival (OS). RESULTS Including all patients, the elevated preoperative LMR was significantly associated with increased TTR and OS in multivariate analysis (HR: 0.47, 95%CI: 0.29-0.76, P=0.002; HR: 0.51, 95%CI: 0.31-0.83, P=0.007; respectively). In subanalyses, the association was limited to patients with stage III (HR: 0.40, 95%CI: 0.22-0.72, P=0.002), in contrast to patients with stage II (HR: 0.40, 95%CI: 0.28-1.66, P=0.397). When the subgroup of patients with 'high-risk' LMR≤2.83 was analysed, no benefit of adjuvant 5-FU-based chemotherapy could be found (HR: 0.99; 95%CI: 0.60-1.63; P=0.953). CONCLUSION The LMR might be an independent prognostic marker for TTR in stage III colon cancer patients. Our results further suggest that high-risk patients based on the LMR do not benefit from adjuvant chemotherapy. Independent validation of our findings is warranted.
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Affiliation(s)
- M Stotz
- Division of Clinical Oncology, Department of Medicine, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria
- Research Unit Genetic Epidemiology and Pharmacogenetics, Division of Clinical Oncology, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria
| | - M Pichler
- Division of Clinical Oncology, Department of Medicine, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria
| | - G Absenger
- Division of Clinical Oncology, Department of Medicine, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria
| | - J Szkandera
- Division of Clinical Oncology, Department of Medicine, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria
- Research Unit Genetic Epidemiology and Pharmacogenetics, Division of Clinical Oncology, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria
| | - F Arminger
- Division of Clinical Oncology, Department of Medicine, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria
| | - R Schaberl-Moser
- Division of Clinical Oncology, Department of Medicine, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria
| | - H Samonigg
- Division of Clinical Oncology, Department of Medicine, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria
| | - T Stojakovic
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria
| | - A Gerger
- Division of Clinical Oncology, Department of Medicine, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria
- Research Unit Genetic Epidemiology and Pharmacogenetics, Division of Clinical Oncology, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria
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Krenn-Pilko S, Langsenlehner U, Thurner E, Stojakovic T, Pichler M, Gerger A, Kapp K, Langsenlehner T. PO-0695: Elevated plasma fibrinogen level represents an independent prognostic factor in breast cancer patients. Radiother Oncol 2014. [DOI: 10.1016/s0167-8140(15)30813-6] [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: 11/17/2022]
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Thurner E, Krenn-Pilko S, Pichler M, Gerger A, Langsenlehner U, Kapp K, Langsenlehner T. PD-0303: Elevated C-reactive protein level predicts poor prognosis in prostate cancer patients treated with radiotherapy. Radiother Oncol 2014. [DOI: 10.1016/s0167-8140(15)30408-4] [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: 11/16/2022]
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Troppan K, Deutsch A, Gerger A, Stojakovic T, Beham-Schmid C, Wenzl K, Neumeister P, Pichler M. The derived neutrophil to lymphocyte ratio is an independent prognostic factor in patients with diffuse large B-cell lymphoma. Br J Cancer 2013; 110:369-74. [PMID: 24357794 PMCID: PMC3899779 DOI: 10.1038/bjc.2013.763] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2013] [Revised: 10/24/2013] [Accepted: 10/31/2013] [Indexed: 12/20/2022] Open
Abstract
Background: With growing evidence on the role of inflammation in cancer biology, the systemic inflammatory response has been postulated as having prognostic significance in a wide range of different cancer types. Recently, the derived neutrophil to lymphocyte ratio (dNLR) has been proposed as an easily determinable prognostic factor in cancer patients. Nevertheless, its prognostic significance in diffuse large B-cell lymphoma (DLBCL) patients has never been explored. Methods: Data from 290 consecutive DLBCL patients, diagnosed between 2004 and 2013 at a single Austrian centre, were evaluated retrospectively. The prognostic influence of the dNLR and other clinico-pathological factors including age, lactate dehydrogenase, cell of origin category and Ann Arbor stage on 5-year overall- (OS) and disease-free (DFS) survival was studied by Kaplan–Meier curves. To evaluate the independent prognostic relevance of dNLR, univariate and multivariate Cox regression models were applied. Results: An independent significant association between high dNLR and poor clinical outcome in multivariate analysis for OS (HR=2.02, confidence interval (CI) 95%=1.17–3.50, P=0.011), as well as DFS (HR=2.15, CI 95%=1.04–4.47, P=0.038), was identified. Conclusion: In the present study, we showed that a high dNLR at diagnosis of DLBCL represents an independent poor prognostic factor for clinical outcome. Our data encourage the further validation of this easily available parameter in prospective studies and as a potential stratification tool in clinical trials.
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Affiliation(s)
- K Troppan
- Division of Hematology, Department of Internal Medicine, Medical University of Graz (MUG), Graz, Austria
| | - A Deutsch
- Division of Hematology, Department of Internal Medicine, Medical University of Graz (MUG), Graz, Austria
| | - A Gerger
- Division of Oncology, Department of Internal Medicine, Medical University of Graz (MUG), Graz, Austria
| | - T Stojakovic
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz (MUG), Graz, Austria
| | - C Beham-Schmid
- Institute of Pathology, Medical University of Graz (MUG), Graz, Austria
| | - K Wenzl
- Division of Hematology, Department of Internal Medicine, Medical University of Graz (MUG), Graz, Austria
| | - P Neumeister
- Division of Hematology, Department of Internal Medicine, Medical University of Graz (MUG), Graz, Austria
| | - M Pichler
- Division of Oncology, Department of Internal Medicine, Medical University of Graz (MUG), Graz, Austria
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Pichler M, Carriere C, Mazzoleni G, Kluge R, Eisendle K. Acne inversa-like lesions associated with the multi-kinase inhibitor sorafenib. Clin Exp Dermatol 2013; 39:232-3. [PMID: 24330088 DOI: 10.1111/ced.12257] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/12/2013] [Indexed: 11/28/2022]
Affiliation(s)
- M Pichler
- Department of Dermatology, Central Teaching Hospital of Bolzano, Bolzano/Bozen, Italy.
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Iwersen M, Klein-Jöbstl D, Pichler M, Roland L, Fidlschuster B, Schwendenwein I, Drillich M. Comparison of 2 electronic cowside tests to detect subclinical ketosis in dairy cows and the influence of the temperature and type of blood sample on the test results. J Dairy Sci 2013; 96:7719-30. [DOI: 10.3168/jds.2013-7121] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2013] [Accepted: 09/02/2013] [Indexed: 11/19/2022]
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