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RISS 인기검색어
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- 저자 : Sven Mahner (검색결과 3 건)
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Fabian Trillsch,Sven Mahner,Bastian Czogalla,Miriam Rottmann,Radoslav Chekerov,Elena Ioana Braicu,Gülten Oskay-Öczelik,Pauline Wimberger,Rolf Richter,Jalid Sehouli 대한부인종양학회 2021 Journal of Gynecologic Oncology Vol.32 No.3
Objective: Patients with platinum-resistant ovarian cancer (PROC) have a high need forreliable prognostic markers. Since significance of primary platinum resistance (PPR) versussecondary platinum resistance (SPR) was identified for patients receiving anti-angiogenictherapy, it has not been confirmed for chemotherapy only. Methods: PROC patients from 3 prospective trials of the NOGGO study group (TOWER,NOGGO-Treosulfan, and TRIAS) were included in this meta-analysis. Exploratory Cox andlogistic regression analyses were performed to correlate progression-free survival (PFS) andoverall survival (OS) with the timing when platinum resistance developed. Results: Of 477 patients, 264 (55.3%) were classified as PPR, compared to 213 (44.7%) withSPR. For patients receiving chemotherapy only, SPR was associated with a significantlylonger median PFS of 3.9 compared to 3.1 months for PPR (hazard ratio [HR]=0.78; p=0.015). SPR versus PPR was confirmed to be an independent prognostic factor for better PFS inmultivariate analysis (HR=0.74; p=0.029). Benefit from adding sorafenib to chemotherapywas mainly seen in PPR (HR=0.40; p<0.001) compared to SPR patients (HR=0.83; p=0.465). Conclusions: Prognostic significance of SPR versus PPR could be elucidated for patientsreceiving chemotherapy only. In contrast to bevacizumab, the multi-kinase inhibitorsorafenib exhibits profound therapeutic efficacy in PPR patients indicating potential toovercome this negative prognostic impact.
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Hannah Woopen,Klaus Pietzner,Rolf Richter,Christina Fotopoulou,Thomas Joens,Elena Ioana Braicu,Håkan Mellstedt,Sven Mahner,Horst Lindhofer,Silvia Darb-Esfahani,Carsten Denkert,Jalid Sehouli 대한부인종양학회 2014 Journal of Gynecologic Oncology Vol.25 No.3
Objective: Epithelial cell adhesion molecule (EpCAM) has experienced a renaissance lately as a binding site for targeted therapy as well as a prognostic marker in epithelial malignancies. Aim of this study was to study EpCAM as a potential prognostic marker in epithelial ovarian cancer (EOC). Methods: EpCAM expression was assessed by immunohistochemistry on paraffin-embedded primary EOC-tissue samples. EpCAM overexpression was defined as an expression of EpCAM of 76% to 100%. Tissue samples and clinical data were systematically collected within the international and multicenter “Tumorbank Ovarian Cancer” network. Results: Seventy-four patients, diagnosed with EOC between 1994 and 2009, were included in the study (median age, 56 years; range, 31 to 86 years). The majority of the patients (81.1%) presented with an advanced stage International Federation of Gynecology and Obstetrics (FIGO) III/IV disease. Histology was of the serous type in 41 patients (55.4%), endometrioid in 19 (25.6%), and mucinous in 14 (19%). EpCAM was overexpressed in 87.7%. Serous tumors overexpressed EpCAM significantly more often than mucinous tumors (87.8% vs. 78.6%, p=0.045); while no significant difference was noted between the other histological subgroups. EpCAM overexpression was significantly associated with a better progression free survival and higher response rates to platinum based chemotherapy (p=0.040 and p=0.048, respectively). EpCAM was identified as an independent prognostic marker for overall survival (p=0.022). Conclusion: Our data indicate a significant association of EpCAM overexpression with a more favorable survival in EOC-patients. Serous cancers showed a significant EpCAM overexpression compared to mucinous types. Larger multicenter analyses are warranted to confirm these findings.
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Theresa Maria Kolben,Lea T Etzel,Florian Bergauer,Ingke Hagemann,Peter Hillemanns,Monika Repper,Andreas M Kaufmann,Karl Sotlar,Thomas Kolben,Hans-Joachim Helms,Julia Gallwas,Sven Mahner,Christian Dann 대한부인종양학회 2019 Journal of Gynecologic Oncology Vol.30 No.3
Objective: To show noninferiority of a limited-excision (resection of the dysplastic lesion only) vs. classical Large Loop Excision of the Transformation Zone (LLETZ).Methods: In this prospective, randomized, multicenter trial, women with human papillomavirus (HPV) positive cervical intraepithelial neoplasia grade 3 were randomized into two groups (1:1). Primary outcome was the rate of negative HPV tests after 6 months, secondary outcomes included cone size, complete resection rates as well as cytological and histological results after 6 and 12 months. A sample size of 1,000 was calculated to show noninferiority of the limited-excision compared to the LLETZgroup using a noninferiority margin of 5%. Enrollment was stopped after 100 patients due to slow accrual.Results: Patients in the limited-excision group did not show a lower number of negative HPV tests (78% [LLETZ]80% [limited-excision]=−2%; 90% confidence interval=−15%, 12%). The limited-excision resulted in a substantially lower cone size (LLETZ: 1.97 mL vs. limitedexcision: 1.02 mL; p<0.001) but higher numbers of involved margins (LLETZ: 8% vs. limitedexcision: 20%). Although postoperative cytological results slightly differed, histological results were similar in both groups. One limited-excision patient received immediate re-conisation, whereas one patient in each group was scheduled for re-conisation after 6 months. Conclusion: The limited-excision could represent a promising option to reduce the surgical extent of conisations while maintaining oncological safety. The trial was not sufficiently powered to reach statistical significance due to early termination. Nevertheless, the study provides important insights in the feasibility of a limited-excision and could serve as a pilot study for future trials.Trial Registration: German Clinical Trials Register Identifier: DRKS00006169
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