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Tanja Fehm Monika Hampl Wolfgang Janni Sherko Kümmel Anton Scharl Peter Mallmann Barbara Schmalfeldt Jalid Sehouli 《Der Gyn?kologe》2016,49(9):670-673
The gynecologist as gynecologic oncologist: Comprehensive knowledge about oncologic diseases of the breast and the female genital tract is an essential part of the residency program in Obstetrics and Gynecology. Medical training includes prevention, diagnostics, surgical, medical as well as complementary therapy and follow-up of female cancer. The fellowship in Gynecologic Oncology aims to deepen these basic skills. Knowledge in diagnosis and indications, respectively, for medical and surgical oncologic treatment strategies is expanded. Surgical skills in oncologic procedures including breast and abdominal surgery are acquired. After finishing the fellowship, the gynecologic oncologist should be capable to indicate, plan and perform medical and surgical treatments in cancerous diseases of the breast and the female genital tract. Moreover, it is essential for gynecologic oncologists to understand and include multidisciplinary treatment strategies in cooperation with radiotherapists, general surgeons and medical oncologists to achieve optimal results for their cancer patients 相似文献
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Clinical feasibility of (neo)adjuvant taxane-based chemotherapy in older patients: analysis of >4,500 patients from four German randomized breast cancer trials 下载免费PDF全文
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It is important for any woman undergoing mastectomy to make an informed decision about reconstruction and to be provided with information about the technique, advantages and disadvantages. There is a high degree of patient satisfaction with breast reconstruction, but high levels of preoperative information and psychological support are necessary. Close collaboration between oncological and reconstructive surgeons or management by an oncoplastic breast surgeon, careful patient selection and counseling, and refinements in surgical techniques can provide a range of safe and predictable techniques for breast reconstruction. After modified radical mastectomy breast reconstruction involves replacement of breast skin and breast volume; after skin-sparing mastectomy only the replacement of breast volume is necessary. The most commonly used surgical techniques are tissue expansion, latissimus dorsi myocutaneous flap with or without implants, and the use of lower abdominal tissue. Until today, the pedicled TRAM flap is the standard method for autologous breast reconstruction. 相似文献
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Till A Heusner Sherko Kuemmel Lale Umutlu Angela Koeninger Lutz S Freudenberg Elke A M Hauth Klaus R Kimmig Michael Forsting Andreas Bockisch Gerald Antoch 《Journal of nuclear medicine》2008,49(8):1215-1222
Our objective was to compare the diagnostic accuracy of an all-in-one protocol of whole-body 18F-FDG PET/CT and integrated 18F-FDG PET/CT mammography with the diagnostic accuracy of a multimodality algorithm for initial breast cancer staging. METHODS: Forty women (mean age, 58.3 y; range, 30.8-78.4 y; SD, 12 y) with suspected breast cancer were included. For the primary tumor, we compared 18F-FDG PET/CT mammography versus MRI mammography; for axillary lymph node status, 18F-FDG PET/CT versus clinical investigation and ultrasound; and for distant metastases, 18F-FDG PET/CT versus a multimodality staging algorithm. Histopathology and clinical follow-up served as the standard of reference. The Fisher exact test evaluated the significance of differences (P < 0.05). Alterations in patient management caused by 18F-FDG PET/CT were documented. RESULTS: No significant differences were found in the detection rate of breast cancer lesions (18F-FDG PET/CT, 95%; MRI, 100%; P = 1). 18F-FDG PET/CT correctly classified lesion focality significantly more often than did MRI (18F-FDG PET/CT, 79%; MRI, 73%; P < 0.001). MRI correctly defined the T stage significantly more often than did 18F-FDG PET/CT (MRI, 77%; 18F-FDG PET/CT, 54%; P = 0.001). 18F-FDG PET/CT detected axillary lymph node metastases in 80% of cases; clinical investigation/ultrasound, in 70%. This difference was not statistically significant (P = 0.067). Distant metastases were detected with 18F-FDG PET/CT in 100% of cases, and the multimodality algorithm identified distant metastases in 70%. This difference was not statistically significant (P = 1). Three patients had extraaxillary lymph node metastases that were detected only by PET/CT (cervical, retroperitoneal, mediastinal/internal mammary group). 18F-FDG PET/CT changed patient management in 12.5% of cases. CONCLUSION: Our data suggest that a whole-body 18F-FDG PET/CT mammography protocol may be used for staging breast cancer in a single session. This initial assessment of the 18F-FDG PET/CT protocol indicates similar accuracy to MRI for the detection of breast cancer lesions. Although MRI seems to be more accurate when assessing the T stage of the tumor, 18F-FDG PET/CT seems able to more accurately define lesion focality. Although 18F-FDG PET/CT mammography was able to detect axillary lymph node metastases with a high sensitivity, this method cannot soon be expected to replace the combination of clinical examination, ultrasound, and sentinel lymph node biopsy for axillary assessment. 相似文献
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Blohmer JU Kimmig R Kummel S Costa SD Kramer S Rezai M 《Gyn?kologisch-geburtshilfliche Rundschau》2008,48(2):63-67
In the systemic therapy of breast cancer, the tumor itself has become the specific target. If possible the surgical excision of breast carcinoma is restricted to the tumor site and aims at an R0 resection of the invasive and preinvasive portions of the carcinoma. Only percutaneous whole-breast radiotherapy irradiates the whole breast. The additional boost irradiation is targeted and significantly improves local control in all age groups. Due to the increased detection of small breast carcinomas in postmenopausal patients by mammographic screening, it is necessary to consider a change of the existing therapeutic practice. Published results of partial irradiation of the breast (intra- as well as postoperatively) show a very high degree of local control with follow-ups of up to 11 years. At present prospective and randomized studies investigate for which patients an intraoperative radiotherapy is sufficient as the sole irradiation method after previous surgery. Intraoperative radiotherapy as a boost preceding percutaneous whole-breast irradiation should already be possible according to a relevant statement of the DEGRO. 相似文献
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Martine Piccart Laura J van 't Veer Coralie Poncet Josephine M N Lopes Cardozo Suzette Delaloge Jean-Yves Pierga Peter Vuylsteke Etienne Brain Suzan Vrijaldenhoven Peter A Neijenhuis Sylvian Causeret Tineke J Smilde Giuseppe Viale Annuska M Glas Mauro Delorenzi Christos Sotiriou Isabel T Rubio Sherko Kümmel Emiel J T Rutgers 《The lancet oncology》2021,22(4):476-488
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Al-Bajalan Mariwan M. M. Niranji Sherko S. Al-Jaf Sirwan M. A. Kato Hirotomo 《Parasitology research》2018,117(2):585-590
Parasitology Research - Canine leishmaniasis (CanL) caused by Leishmania infantum (L. infantum) is considered as a zoonotic disease and within the last few decades, studies have identified the... 相似文献
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Kümmel S Krocker J Kohls A Breitbach GP Morack G Budner M Blohmer JU Lichtenegger W Elling D 《Critical reviews in oncology/hematology》2006,58(2):166-175
To evaluate the feasibility and tolerability of dose-dense adjuvant chemotherapy for older patients with node-positive breast cancer, a retrospective subset analysis compared dose delays and dose reductions for women aged > or = 60 years with those of younger women. Patients were randomized to a dose-dense (DD, 14-day cycle) or conventional-schedule (CS, 21-day cycle) regimen. DD patients (n = 104; 25 aged > or = 60 years) received epirubicin 90 mg/m2 plus paclitaxel 175 mg/m2 (four cycles), then cyclophosphamide 600 mg/m2, methotrexate 40 mg/m2 and fluorouracil 600 mg/m2 (CMF 600/40/600) (three cycles), plus filgrastim 5 microg/kg per day in every cycle. CS patients (n = 107; 27 aged > or = 60 years) received epirubicin 90 mg/m2 plus cyclophosphamide 600 mg/m2 (four cycles), then CMF 600/40/600 (three cycles), plus filgrastim if required. Delays were more common in older patients in both the DD and CS groups (DD, 17% versus 6%; CS, 11% versus 6%), as were Grades 3-4 leukopenia (26% versus 12%) and neutropenia (33% versus 25%). All older DD and 89% of older CS patients received all seven chemotherapy cycles, with 99% of cycles at full dose. This study demonstrates that a dose-dense regimen combining epirubicin and paclitaxel can be administered to patients > or = 60 years of age with a tolerable safety profile. 相似文献
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Matthias Christgen MD PhD Oleg Gluz MD Nadia Harbeck MD Ronald E. Kates PhD Mieke Raap MD Henriette Christgen Michael Clemens MD Wolfram Malter MD Benno Nuding MD Bahriye Aktas MD Sherko Kuemmel MD Toralf Reimer MD Andrea Stefek MD Petra Krabisch MD Marianne Just MD Doris Augustin MD Monika Graeser MD Frederick Baehner MD Rachel Wuerstlein MD Ulrike Nitz MD Hans Kreipe MD the West German Study Group PlanB Investigators 《Cancer》2020,126(22):4847-4858