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Bad Essen, Germany

Ataseven B.,Evangelische Huyssens Stiftung | Harter P.,Evangelische Huyssens Stiftung | Grimm C.,Evangelische Huyssens Stiftung | Grimm C.,Medical University of Vienna | And 7 more authors.
Gynecologic Oncology

Objective: The revised 2014 FIGO staging system for epithelial ovarian cancer (EOC) included many changes of the previous system, particularly dividing FIGO stage IV in two subgroups. We evaluated if classifying patients with EOC in FIGO stage IVA and IVB has any prognostic implication. © 2016 Elsevier Inc. Source

Ataseven B.,Evangelische Huyssens Stiftung | Kummel S.,The Interdisciplinary Center | Weikel W.,Dr. Horst Schmidt Kliniken | Heitz F.,Evangelische Huyssens Stiftung | And 8 more authors.
Archives of Gynecology and Obstetrics

Purpose: Although the impact of lymph node ratio (LNR: ratio of metastatic to resected LNs) in breast cancer (BC) has been investigated, its prognostic value in molecular subtypes remains unclear. Our aim was to evaluate the impact of LNR compared to pN-stage in BC subtypes.Patients/methods: We analyzed the impact of LNR and pN-stage on disease-free (DFS) and overall survival (OS) in 1,656 patients with primary BC who underwent primary axillary surgery (removal of ≥10 LNs) between 1998 and 2011. The cut-off points for LNR were previously published. Using immunohistochemical parameters tumors were grouped in luminalA, luminalB/HER2−, luminalB/HER2+, HER2+ and triple negative (TNBC).Results: For the entire cohort 5/10-year DFS and OS rates were 88/77 % and 88/75 %, respectively. LNR and pN-stage were independent prognostic parameters for DFS/OS in multivariate analysis in the entire cohort and each molecular subgroup (p < 0.001). However, increasing LNR seemed to discriminated 10-year DFS slightly better than pN-stage in luminalA (intermediate/high LNR 65/44 % versus pN2/pN3 71/53 %), luminalB/HER2− (intermediate/high LNR 48/24 % versus pN2/pN3 41/42 %), and TNBC patients (intermediate/high LNR 49/24 % versus pN2/pN3 56/33 %).Conclusions: LNR is an important prognostic parameter for DFS/OS and might provide potentially more information than pN-stage in different molecular subtypes. © 2014, European Union. Source

Heitz F.,Evangelische Huyssens Stiftung | Barinoff J.,Evangelische Huyssens Stiftung | Du Bois O.,Dr. Horst Schmidt Kliniken | Hils R.,Dr. Horst Schmidt Kliniken | And 6 more authors.
Oncology (Switzerland)

Objective: Receptor discordances between primary and recurrent breast cancer have been described for years, but only a few analyses have elucidated the factors that influence receptor changes. Methods: Explorative analyses of prospective data from a breast cancer database of a tertiary breast cancer unit. Results: Recurrent tumours that had expressed oestrogen (ER) and progesterone receptors (PR) and human epidermal growth factor receptor 2 (HER2) as primary tumours were negative for the respective receptor in 22.8, 41.4 and 40.8% of cases. ER, PR and HER2 expression was found in 19.8, 16.7 and 11.5% of recurrent tumours, although no expression had been observed in primary tumours. Receptor discordances in recurrent disease leading to different therapeutic approaches were noted in 126 of 411 patients (30.7%). In patients with tumours expressing primary ER and HER2, independent factors associated with discordance were endocrine therapy and treatment with trastuzumab. Conclusion: High rates of receptor discordance were found. The impact of factors that influence receptor changes is small so that no subgroup of patients with recurrent breast cancer should be excluded from biopsy. Whenever possible, a biopsy should be taken to confirm the diagnosis of a possible relapse as well as the receptor status of patients with breast cancer. Copyright © 2013 S. Karger AG, Basel. Source

Ataseven B.,Evangelische Huyssens Stiftung | Du Bois A.,Evangelische Huyssens Stiftung | Reinthaller A.,Medical University of Vienna | Traut A.,Evangelische Huyssens Stiftung | And 7 more authors.
Gynecologic Oncology

Objective Hypoalbuminemia has been reported as a risk factor for post-operative complications and unfavorable survival in cancer patients. We aimed to evaluate the predictive value of preoperative serum albumin levels on post-operative complication rate and the impact on overall survival (OS) in patients with epithelial ovarian cancer (EOC) undergoing primary cytoreductive surgery. Methods The present retrospective study included 604 consecutive patients with EOC who underwent primary cytoreductive surgery at two tertiary cancer centers specialized in gynecologic oncology. Hypoalbuminemia was defined as a pre-operative serum albumin level ≤ 35 g/L. Post-operative surgical complications were graded according to the Clavien-Dindo-Classification (CDC). Fisher-test was used to investigate the predictive value of hypoalbuminemia on the rate of severe post-operative complications. Survival analyses were calculated using log-rank test and Cox regression models. Results The incidence of pre-operative hypoalbuminemia in the entire cohort was 16.4%. Hypoalbuminemia was a predictive factor for severe post-operative complications (CDC 3-5) (OR 3.65, (CI95% 1.59 - 8.39); p = 0.002). Furthermore, median overall survival time of patients with hypoalbuminemia was 24 months compared to 83 months in patients with normal albumin (p < 0.001), respectively. Hypoalbuminemia was independently associated with shortened overall survival (HR 2.2 (95% CI 1.6-3.0); p < 0.001) even after adjusting established prognostic factors such as age, tumor stage, performance status, and post-operative residual disease. Conclusion Pre-operative hypoalbuminemia can be used as both an independent predictive factor for severe post-operative complications and as prognostic parameter regarding overall survival in EOC patients. Therefore, albumin levels may be incorporated into future clinical trials as stratification factor. © 2015 Elsevier Inc. Source

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