Frauenklinik des Universitatsklinikums Erlangen

Erlangen, Germany

Frauenklinik des Universitatsklinikums Erlangen

Erlangen, Germany

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Von Minckwitz G.,C o GBG Forschungs GmbH | Von Minckwitz G.,Universitats Frauenklinik Frankfurt | Schmitt W.D.,Charite University Hospital | Loibl S.,C o GBG Forschungs GmbH | And 18 more authors.
Clinical Cancer Research | Year: 2013

Purpose: The value of Ki67 measured on residual disease after neoadjuvant chemotherapy is not sufficiently described. Experimental Design: Participants of the GeparTrio study with primary breast cancer randomly received neoadjuvant response-guided [8 cycles TAC (docetaxel/doxorubicin/cyclophosphamide) in responding and TAC-NX (vinorelbine/capecitabine) in nonresponding patients] or conventional (6 cycles TAC) chemotherapy according to interim response assessment. Ki-67 levels were centrally measured immunohistochemically after neoadjuvant treatment if tumor tissue was available. Here, we analyze 1,151 patients having a pathologic complete response (pCR; n, 484), or residual disease with low (0-15%), intermediate (15.1-35%), or high (35.1-100%) posttreatment Ki67 levels in 488, 77, and 102 patients, respectively. Results: Patients with high posttreatment Ki67 levels showed higher risk for disease relapse (P < 0.0001) and death (P < 0.0001) compared with patients with low or intermediate Ki67 levels. Patients with low Ki67 levels showed a comparable outcome to patients with a pCR (P = 0.211 for disease-free and P = 0.779 for overall survival). Posttreatment Ki67 levels provided more prognostic information than pretreatment Ki67 levels or changes of Ki67 from pre- to posttreatment. Information on pCR plus posttreatment Ki67 levels surmount the prognostic information of pCR alone in hormone-receptorpositive disease [hazard ratios (HR), 1.82-5.88] but not in hormone-receptor-negative disease (HR: 0.61-1.73). Patients with conventional and response-guided treatment did not show a different distribution of posttreatment Ki67 (P = 0.965). Conclusions: Posttreatment Ki67 levels provide prognostic information for patients with hormone-receptor-positive breast cancer and residual disease after neoadjuvant chemotherapy. Levels were not prognostic for outcome after response-guided chemotherapy. High posttreatment Ki67 indicates the need for innovative postneoadjuvant treatments. © 2013 American Association for Cancer Research.


PubMed | Institute For Pathologie, Gemeinschaftspraxis Gynakologie und Geburtshilfe, Gynakologisch Onkologische Praxis, Frauenklinik and 16 more.
Type: Journal Article | Journal: Breast care (Basel, Switzerland) | Year: 2015

The key topics of this years 14th St. Gallen Consensus Conference on the diagnosis and therapy of primary breast cancer were again questions about breast surgery and axillary surgery, radio-oncology and systemic therapy options in consideration of tumor biology, and the clinical application of multigene assays. This year, the consensus conference took place in Vienna. From a German perspective, it makes sense to substantiate the results of the vote of the international panel representing 19 countries in light of the updated national therapy recommendations of the AGO (Arbeitsgemeinschaft Gynkologische Onkologie). Therefore, 14 German breast cancer experts, 3 of whom are members of the International St. Gallen Panel, have commented on the voting results of the St. Gallen Consensus Conference 2015 in relation to clinical routine in Germany.


Isachenko V.,Universitatsfrauenklinik Cologne | Dittrich R.,Frauenklinik des Universitatsklinikums Erlangen | Keck G.,Universitatsfrauenklinik Dresden | Isachenko E.,Universitatsfrauenklinik Cologne | And 8 more authors.
Geburtshilfe und Frauenheilkunde | Year: 2012

Purpose: In many cases cancer therapy leads to an irreversible reduction or even loss of ovarian reserve. Cryopreservation of ovarian tissue with subsequent thawing and re-transplantation of tissue after the cancer is in remission constitutes a promising method to preserve fertility in women. To date, more than 25 cases of live births after re-transplantation of cryopreserved ovarian tissue have been published worldwide. In Germany the first live birth after re-transplantation of cryopreserved tissue was in 2011. Material and Methods: After surgical removal of ovarian tissue in the Gynaecological Clinic of Dresden University, the tissue was sent to the Gynaecological Clinic of Bonn University in a special transport container at 5°C and was frozen the next day using 1.5M dimethyl sulfoxide cryosolution. In 2010 this ovarian tissue was thawed using a sucrose solution in the Gynaecological Clinic of Erlangen University Clinical Centre and was laparoscopically re-transplanted into the patient. Results: The patient became pregnant, the pregnancy was uneventful, and she gave birth to a healthy boy. Conclusion: Freezing of ovarian tissue with subsequent re-transplantation as described here is a viable method to preserve fertility in cancer patients. © Georg Thieme Verlag KG Stuttgart · New York.


Kummel S.,Knappschaft GmbH | Kolberg H.C.,Marienhospital Bottrop | Luftner D.,Medizinische Klinik und Poliklinik II | Lux M.P.,Frauenklinik des Universitatsklinikums Erlangen | And 6 more authors.
Geburtshilfe und Frauenheilkunde | Year: 2011

The treatment options for primary and metastatic breast cancer patients as well as the characteristics considered for therapy decision continue to become more diverse. New target therapies in combination with established chemotherapy regimens extend the range, however, potentially promising combinations do not always result in a benefit for the patient. Latest pharmacogenomics results hint towards prognosis and predictive factors, which do not only focus on the individual properties of the tumor, they also consider the hereditary genetics of the patient. As a result, state of the art therapy decision includes classical clinical as well as modern molecular biomarkers, however, pharmacoeconomic aspects continue to increase in importance in physicians' treatment algorithms. This review builds on the recent congresses, which present new data on the treatment of breast cancer. The last included one is the Annual Meeting of the American Society of Clinical Oncology (ASCO) 2011. © Georg Thieme Verlag KG Stuttgart - New York.


Fasching P.A.,University of California at Los Angeles | Fasching P.A.,Frauenklinik des Universitatsklinikums Erlangen | Fehm T.,Frauenklinik des Universitatsklinikums Tubingen | Janni W.,Frauenklinik des Universitatsklinikums Dusseldorf | And 4 more authors.
Geburtshilfe und Frauenheilkunde | Year: 2010

The treatment options for primary and metastatic breast cancer patients as well as the characteristics considered for therapy decision continue to become more diverse. New target therapies in combination with established chemotherapy regimens extend the range, however, potentially promising combinations do not always result in a benefit for the patient. Latest pharmacogenomics results hint towards prognosis and predictive factors, which do not only focus on the individual properties of the tumor, they also consider the hereditary genetics of the patient. As a result, state of the art therapy decision includes classical clinical as well as modern molecular biomarkers, however, pharmacoeconomic aspects continue to increase in importance in physicians' treatment algorithms. The Annual Meeting of the American Society of Clinical Oncology (ASCO) 2010 in Chicago revealed latest data for all aspects of the breast cancer therapy algorithm and allowed for partially controversial discussions. © Georg Thieme Verlag KG Stuttgart - New York.


Beckmann M.W.,Frauenklinik des Universitatsklinikums Erlangen | Schlieter H.,TU Dresden | Richter P.,TU Dresden | Wesselmann S.,Deutsche Krebsgesellschaft E.V.
Geburtshilfe und Frauenheilkunde | Year: 2016

Medical guidelines have become established as the standard for the comprehensive synopsis of all available information (scientific trials, expert opinion) on diagnosis and treatment recommendations. The transfer of guidelines to clinical practice and subsequent monitoring has however proven difficult. In particular the potential interaction between guideline developers and guideline users has not been fully utilised. This review article analyses the status quo and existing methodological and technical information solutions supporting the guideline life cycle. It is shown that there are numerous innovative developments that in isolation do not provide comprehensive support. The vision of the "Living Guidelines 2.0" is therefore presented. This outlines the merging of guideline development and implementation on the basis of clinical pathways and guideline-based quality control, and building on this, the generation of information for guideline development and research. © Georg Thieme Verlag KG.


Fehm T.,Frauenklinik des Universitatsklinikums Tubingen | Fehm T.,Universitats Frauenklinik Tubingen | Janni W.,Frauenklinik des Universitatsklinikums Dusseldorf | Kummel S.,Klinik fur Senologie | And 5 more authors.
Geburtshilfe und Frauenheilkunde | Year: 2011

The treatment options for primary and metastatic breast cancer patients and the factors considered in the decision for therapy continue to become ever more diverse. New targeted therapies in combination with established chemotherapy regimens have extended the range; however, potentially promising combinations do not always result in benefits for the patient. The latest pharmacogenomics results hint at prognostic and predictive factors which not only focus on the tumor's individual properties but also take account of the patient's hereditary genetics. As a result, state-of-the-art therapy decisions include classical clinical as well as modern molecular biomarkers; however, pharmacoeconomic aspects are also becoming increasingly important in clinical practice. The 33rd San Antonio Breast Cancer Symposium 2010 (SABCS 2010), held Dec 814, 2010, presented the latest data on all aspects of the breast cancer therapy algorithm with a significant role accorded to neoadjuvant therapies. © Georg Thieme Verlag KG Stuttgart - New York.


Dorr H.G.,Universitatsklinikum Erlangen Nurnberg | Binder G.,University of Tübingen | Reisch N.,Ludwig Maximilians University of Munich | Gembruch U.,University of Bonn | And 3 more authors.
Geburtshilfe und Frauenheilkunde | Year: 2015

Purpose: This guideline of the German Society of Pediatric Endocrinology and Diabetology (DGKED) is designed to be experts opinion on the current concept of prenatal therapy for congenital adrenal hyperplasia due to 21-hydroxylase deficiency (CAH). Several scientific medical societies have also participated in the guideline. It aims to offer guidance to physicians when they counsel affected families about prenatal therapy. Methods: The experts commissioned by the medical societies developed a consensus in an informal process. The consensus was subsequently confirmed by the steering committees of the respective medical societies. Recommendations: Prenatal CAH therapy is an experimental therapy. We recommend designing and using standardized protocols for the prenatal diagnosis, therapy and long-term follow-up of women and children treated prenatally with dexamethasone. If long-term follow-up is not possible, then prenatal therapy should not be performed. © Georg Thieme Verlag KG Stuttgart New York.


Lux M.P.,Frauenklinik des Universitatsklinikums Erlangen | Gerber B.,Frauenklinik des Universitatsklinikums Erlangen | Bani M.R.,Frauenklinik des Universitatsklinikums Erlangen | Fasching P.A.,Frauenklinik des Universitatsklinikums Erlangen | And 3 more authors.
Gynakologische Praxis | Year: 2012

Although patients often demand an intensified follow-up care with more diagnostic procedures (e.g. X-ray, CT, MRI, PET and tumour markers), there is actual no existing data or recommendations. By this, no intensified follow-up care but an intensification of follow-up care should be performed. Key words are here an intensification of the dialogue with the patient, the compliance with endocrine therapies, the participation in the recommended procedures in the recommended intervals and the advice about lifestyle.


PubMed | TU Dresden, Deutsche Krebsgesellschaft e. V. and Frauenklinik des Universitatsklinikums Erlangen
Type: Review | Journal: Geburtshilfe und Frauenheilkunde | Year: 2016

Medical guidelines have become established as the standard for the comprehensive synopsis of all available information (scientific trials, expert opinion) on diagnosis and treatment recommendations. The transfer of guidelines to clinical practice and subsequent monitoring has however proven difficult. In particular the potential interaction between guideline developers and guideline users has not been fully utilised. This review article analyses the status quo and existing methodological and technical information solutions supporting the guideline life cycle. It is shown that there are numerous innovative developments that in isolation do not provide comprehensive support. The vision of the Living Guidelines 2.0 is therefore presented. This outlines the merging of guideline development and implementation on the basis of clinical pathways and guideline-based quality control, and building on this, the generation of information for guideline development and research.

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