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1. Fachkliniken – Definition: Vorschlag zur Diskussion aus der Ad-hoc-Kommission Versorgungsstrukturen der Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften (AWMF) zur Reform der Krankenhausversorgung

Author

Randerath, Winfried J., Kriegmair, Martin, Markewitz, Andreas, Rodeck, Burkhard, Schmitz-Rixen, Thomas, Scharl, Anton, and Nothacker, Monika

Subjects
specialist clinics, international classification of diseases (icd), german procedure classification (ops), structure element, patient care, Medicine
Abstract

Specialist clinics play an important role in inpatient care in the German healthcare system. They are characterized by a high degree of specialization and expertise and are described in numerous medical disciplines. However, a generally accepted legal definition of specialist clinics has so far been lacking. The ad hoc committee of the Association of the Scientific Medical Societies in Germany (AWMF) for the reform of hospital care in Germany, therefore, presents proposals for a definition, a description of quality characteristics, and an allocation to care levels. In the opinion of the committee, three aspects are necessary for the definition of specialist clinics: a high total number of patients treated, a high proportion of the disease entities attributable to the specialist area according to diagnosis and services, and structural characteristics. The definition proposed here is intended to help the political decision-makers in the federal and state governments to standardize according to medical-scientific criteria.

Published
2023
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14. Treatment in Certified Breast Cancer Centers Improves Chances of Survival of Patients with Breast Cancer: Evidence Based on Health Care Data from the WiZen Study.

Author

Schoffer, Olaf, Wimberger, Pauline, Gerken, Michael, Bierbaum, Veronika, Bobeth, Christoph, Rößler, Martin, Dröge, Patrik, Ruhnke, Thomas, Günster, Christian, Kleihues-van Tol, Kees, Link, Theresa, Scharl, Anton, Inwald, Elisabeth C., Kast, Karin, Papathemelis, Thomas, Ortmann, Olaf, Klinkhammer-Schalke, Monika, and Schmitt, Jochen

Published
2024
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17. Gynecologic oncologists’ attitudes and practices relating to integrative medicine: results of a nationwide AGO survey

Author

Klein, Evelyn, Beckmann, Matthias W., Bader, Werner, Brucker, Cosima, Dobos, Gustav, Fischer, Dorothea, Hanf, Volker, Hasenburg, Annette, Jud, Sebastian M., Kalder, Matthias, Kiechle, Marion, Kümmel, Sherko, Müller, Andreas, Müller, Myrjam-Alice T., Paepke, Daniela, Rotmann, Andre-Robert, Schütz, Florian, Scharl, Anton, Voiss, Petra, Wallwiener, Markus, Witt, Claudia, and Hack, Carolin C.

Published
2017
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19. Shared decision-making in metastatic breast cancer: discrepancy between the expected prolongation of life and treatment efficacy between patients and physicians, and influencing factors

Author

Lux, Michael P., Bayer, Christian M., Loehberg, Christian R., Fasching, Peter A., Schrauder, Michael G., Bani, Mayada R., Häberle, Lothar, Engel, Anne, Heusinger, Katharina, Tänzer, Thorsten, Radosavac, Dragan, Scharl, Anton, Bauerfeind, Ingo, Gesslein, Judith, Schulte, Hilde, Overbeck-Schulte, Brigitte, Beckmann, Matthias W., and Hein, Alexander

Published
2013
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20. Financing of certified centers: a willingness-to-pay analysis

Author

Thiel, Falk C., Scharl, Anton, Hildebrandt, Thomas, Kotziabassis, Efstratios, Schrauder, Michael G., Bani, Mayada R., Müller, Andreas, Hauzenberger, Tanja, Loehberg, Christian R., Jud, Sebastian M., Fasching, Peter A., Hartmann, Arndt, Schulz-Wendtland, Rüdiger, Strnad, Vratislav, Beckmann, Matthias W., and Lux, Michael Patrick

Published
2013
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23. Dihydropyrimidine dehydrogenase testing prior to treatment with 5-Fluorouracil, Capecitabine, and Tegafur

Author

Wörmann, Bernhard (Prof. Dr. med.), Bokemeyer, Carsten (Prof. Dr. med.), Burmeister, Thomas (PD Dr. Dr. med.), Köhne, Claus-Henning (Prof. Dr. med.), Schwab, Matthias (Prof. Dr. med.), Arnold, Dirk (Prof. Dr. med.), Blohmer, Jens-Uwe, Borner, Markus, Brucker, Sara (Dr. med.), Cascorbi, Ingolf (Prof. Dr. med. Dr. rer. nat.), Decker, Thomas (Prof. Dr. med.), Wit, Maike de, Dietz, Andreas (Prof. Dr. med.), Einsele, Hermann (Prof. Dr. med.), Eisterer, Wolfgang, Folprecht, Gunnar (PD Dr. med.), Hilbe, Wolfgang (Prim. Univ.-Prof. Dr.), Hoffmann, Jürgen (Prof. Dr. med. Dr. med. dent.), Knauf, Wolfgang (Dr. med.), Kunzmann, Volker (Prof. Dr. med.), Largiadèr, Carlo R., Lorenzen, Sylvie (Dr. med.), Lüftner, Diana (Prof. Dr. med.), Moehler, Markus (Prof. Dr. med.), Nöthen, Markus M. (Prof. Dr.), Pox, Christian P. (Prof. Dr. med.), Reinacher-Schick, Anke Claudia (Prof. Dr. med.), Scharl, Anton, Schlegelberger, Brigitte (Prof. Dr. med.), Seufferlein, Thomas (Prof. Dr. med.), Sinn, Marianne (Prof. Dr. med.), Stroth, Matthias (Dr. med.), Tamm, Ingo (Dr. med.), Trümper, Lorenz, Wilhelm, Martin (Prof. Dr. med.), Wöll, Ewald (Prim. Univ.-Prof. Dr.), and Hofheinz, Ralf-Dieter (Prof. Dr. med.)

Subjects
ddc:610
Abstract

\(\bf Background:\) 5-Fluorouracil (FU) is one of the most commonly used cytostatic drugs in the systemic treatment of cancer. Treatment with FU may cause severe or life-threatening side effects and the treatment-related mortality rate is 0.2–1.0%. \(\bf Summary:\) Among other risk factors associated with increased toxicity, a genetic deficiency in dihydropyrimidine dehydrogenase (DPD), an enzyme responsible for the metabolism of FU, is well known. This is due to variants in the DPD gene (DPYD). Up to 9% of European patients carry a DPD gene variant that decreases enzyme activity, and DPD is completely lacking in approximately 0.5% of patients. Here we describe the clinical and genetic background and summarize recommendations for the genetic testing and tailoring of treatment with 5-FU derivatives. The statement was developed as a consensus statement organized by the German Society for Hematology and Medical Oncology in cooperation with 13 medical associations from Austria, Germany, and Switzerland. \(\bf Key Messages:\) (i) Patients should be tested for the 4 most common genetic DPYD variants before treatment with drugs containing FU. (ii) Testing forms the basis for a differentiated, risk-adapted algorithm with recommendations for treatment with FU-containing drugs. (iii) Testing may optionally be supplemented by therapeutic drug monitoring.

Published
2020

31. Interdisziplinäre Früherkennung, Diagnostik, Therapie und Nachsorge des Mammakarzinoms : Leitlinie der DGGG und DKG (S3-Level, AWMF-Registernummer 032/045OL, Dezember 2017) – Teil 1 mit Empfehlungen zur Früherkennung, Diagnostik und Nachsorge des Mammakarzinoms

Author

Wöckel, Achim, Festl, Jasmin, Stüber, Tanja, Brust, Katharina, Stangl, Stephanie, Heuschmann, Peter Ulrich, Albert, Ute Susann, Budach, Wilfried, Follmann, Markus, Janni, Wolfgang, Kopp, Ina, Kreienberg, Rolf, Kühn, Thorsten, Langer, Thomas, Nothacker, Monika, Scharl, Anton, Schreer, Ingrid, Link, Hartmut, Engel, Jutta, Fehm, Tanja, Weis, Joachim, Welt, Anja, Steckelberg, Anke, Feyer, Petra, König, Klaus, Hahne, Andrea, Kreipe, Hans H., Knoefel, Wolfram Trudo, Denkinger, Michael, Brucker, Sara, Lüftner, Diana, Kubisch, Christian, Gerlach, Christina, Lebeau, Annette, Siedentopf, Friederike, Petersen, Cordula, Bartsch, Hans Helge, Schulz-Wendtland, Rüdiger, Hahn, Markus, Hanf, Volker, Müller-Schimpfle, Markus, Henscher, Ulla, Roncarati, Renza, Katalinic, Alexander, Heitmann, Christoph, Honegger, Christoph, Paradies, Kerstin, Bjelic-Radisic, Vesna, Degenhardt, Friedrich, Wenz, Frederik, Rick, Oliver, Hölzel, Dieter, Zaiss, Matthias, Kemper, Gudrun, Budach, Volker, Denkert, Carsten Michael, Gerber , Bernd, Tesch, Hans, Hirsmüller, Susanne, Sinn, Hans-Peter, Dunst, Jürgen, Münstedt, Karsten, Bick, Ulrich, Fallenberg, Eva, Tholen, Reina, Hung, Roswita, Baumann, Freerk T., Beckmann, Matthias Wilhelm, Blohmer, Jens-Uwe, Fasching, Peter Andreas, Lux, Michael Patrick, Harbeck, Nadia, Hadji, Peyman, Hauner, Hans, Heywang-Köbrunner, Sylvia H., Huober, Jens, Hübner, Jutta, Jackisch, Christian, Loibl, Sibylle, Lück, Hans-Jürgen, Minckwitz, Gunter von, Möbus, Volker, Müller, Volkmar, Nöthlings, Ute, Schmidt, Marcus, Schmutzler, Rita Katharina, Schneeweiss, Andreas, Schütz, Florian, Stickeler, Elmar, Thomssen, Christoph, Untch, Michael, Wesselmann, Simone, Bücker, Arno, and Krockenberger, Mathias

Subjects
ddc:610
Abstract

Purpose: The aim of this official guideline coordinated and published by the German Society for Gynecology and Obstetrics (DGGG) and the German Cancer Society (DKG) was to optimize the screening, diagnosis, therapy and follow-up care of breast cancer. Methods: The process of updating the S3 guideline dating from 2012 was based on the adaptation of identified source guidelines which were combined with reviews of evidence compiled using PICO (Patients/Interventions/Control/Outcome) questions and the results of a systematic search of literature databases and the selection and evaluation of the identified literature. The interdisciplinary working groups took the identified materials as their starting point to develop recommendations and statements which were modified and graded in a structured consensus procedure. Recommendations: Part 1 of this short version of the guideline presents recommendations for the screening, diagnosis and follow-up care of breast cancer. The importance of mammography for screening is confirmed in this updated version of the guideline and forms the basis for all screening. In addition to the conventional methods used to diagnose breast cancer, computed tomography (CT) is recommended for staging in women with a higher risk of recurrence. The follow-up concept includes suggested intervals between physical, ultrasound and mammography examinations, additional high-tech diagnostic procedures, and the determination of tumor markers for the evaluation of metastatic disease. Ziele: Das Ziel dieser offiziellen Leitlinie, die von der Deutschen Gesellschaft für Gynäkologie und Geburtshilfe (DGGG) und der Deutschen Krebsgesellschaft (DKG) publiziert und koordiniert wurde, ist es, die Früherkennung, Diagnostik, Therapie und Nachsorge des Mammakarzinoms zu optimieren. Methoden: Der Aktualisierungsprozess der S3-Leitlinie aus 2012 basierte zum einen auf der Adaptation identifizierter Quellleitlinien und zum anderen auf Evidenzübersichten, die nach Entwicklung von PICO-(Patients/Interventions/Control/Outcome-)Fragen, systematischer Recherche in Literaturdatenbanken sowie Selektion und Bewertung der gefundenen Literatur angefertigt wurden. In den interdisziplinären Arbeitsgruppen wurden auf dieser Grundlage Vorschläge für Empfehlungen und Statements erarbeitet, die im Rahmen von strukturierten Konsensusverfahren modifiziert und graduiert wurden. Empfehlungen: Der Teil 1 dieser Kurzversion der Leitlinie zeigt Empfehlungen zur Früherkennung, Diagnostik und Nachsorge des Mammakarzinoms: Der Stellenwert des Mammografie-Screenings wird in der aktualisierten Leitlinienversion bestätigt und bildet damit die Grundlage der Früherkennung. Neben den konventionellen Methoden der Karzinomdiagnostik wird die Computertomografie (CT) zum Staging bei höherem Rückfallrisiko empfohlen. Die Nachsorgekonzepte beinhalten Untersuchungsintervalle für die körperliche Untersuchung, Ultraschall und Mammografie, während weiterführende Gerätediagnostik und Tumormarkerbestimmungen bei der metastasierten Erkrankung Anwendung finden.

Published
2018

32. Comparison of survival outcomes and effects of therapy between subtypes of high-grade endometrial cancer – a population-based study.

Author

Scharl, Sophia, Gerken, Michael, Sprötge, Tim, Kronberger, Karin, Scharl, Anton, Ignatov, Atanas, Ortmann, Olaf, Kölbl, Oliver, Klinkhammer-Schalke, Monika, and Papathemelis, Thomas

Subjects
STATISTICS, CONFIDENCE intervals, MULTIVARIATE analysis, RETROSPECTIVE studies, TREATMENT effectiveness, TUMOR classification, CANCER patients, DISEASE relapse, ENDOMETRIAL tumors, DESCRIPTIVE statistics, TUMOR grading, SARCOMA
Abstract

Similarities in outcome between grade 3 endometrioid cancer and non-endometrioid histologies have been reported by a number of studies. Other reports, however, stated a significantly better prognosis for G3 endometrioid compared to type II histology. In this population-based study, we compared the outcome and treatment approaches of high-grade endometrial cancer patients with FIGO stages I–III depending on their histology. 284 high-grade endometrial cancer patients diagnosed between 1998 and 2015 were retrospectively analyzed. Overall survival (OS), recurrence-free survival (RFS), and recurrence rates were compared depending on histology. Type I G3 patients had a statistically significant OS advantage over women suffering from type II carcinoma (HR 1.527, 95%-CI 1.024–2.276; p = 0.038) and carcinosarcoma (HR 2.106, 95%-CI 1.270–3.493; p = 0.004) in univariable and multivariable Cox-regression analysis. RFS in Type I G3 was significantly superior compared to patients with carcinosarcoma (HR 1.719, 95%-CI 1.018–2.901; p = 0.043) and not significantly superior to type II patients (HR 1.368, 95%-CI 0.920–2.036; p = 0.122). Cumulative recurrence rates were significantly higher in carcinosarcoma compared to type I G3 (HR 2.217, 95%-CI 1.096–4.485; p = 0.027) in univariable analysis, but not after risk adjustment (HR of 1.472, 95%-CI 0.654–3.311; p = 0.350). The prognosis of patients with type I G3 endometrial cancer patients seems to be significantly superior to patients with type II cancer and particularly carcinosarcoma. Systematic LND seemed to be beneficial in all of the three subtypes. The benefit of adjuvant treatment methods may differ between histologies. [ABSTRACT FROM AUTHOR]

Published
2021
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33. Interdisziplinäre Früherkennung, Diagnostik, Therapie und Nachsorge des Mammakarzinoms : Leitlinie der DGGG und DKG (S3-Level, AWMF-Registernummer 032/045OL, Dezember 2017) – Teil 2 mit Empfehlungen zur Therapie des primären, rezidivierten und fortgeschrittenen Mammakarzinoms

Author

Wöckel, Achim, Festl, Jasmin, Stüber, Tanja, Brust, Katharina, Krockenberger, Mathias, Heuschmann, Peter U, Jírů-Hillmann, Steffi, Albert, Ute-Susann, Budach, Wilfried, Follmann, Markus, Janni, Wolfgang, Kopp, Ina, Kreienberg, Rolf, Kühn, Thorsten, Langer, Thomas, Nothacker, Monika, Scharl, Anton, Schreer, Ingrid, Link, Hartmut, Engel, Jutta, Fehm, Tanja, Weis, Joachim, Welt, Anja, Steckelberg, Anke, Feyer, Petra, König, Klaus, Hahne, Andrea, Baumgartner, Traudl, Kreipe, Hans H, Knoefel, Wolfram Trudo, Denkinger, Michael, Brucker, Sara, Lüftner, Diana, Kubisch, Christian, Gerlach, Christina, Lebeau, Annette, Siedentopf, Friederike, Petersen, Cordula, Bartsch, Hans Helge, Schulz-Wendtland, Rüdiger, Hahn, Markus, Hanf, Volker, Müller-Schimpfle, Markus, Henscher, Ulla, Roncarati, Renza, Katalinic, Alexander, Heitmann, Christoph, Honegger, Christoph, Paradies, Kerstin, Bjelic-Radisic, Vesna, Degenhardt, Friedrich, Wenz, Frederik, Rick, Oliver, Hölzel, Dieter, Zaiss, Matthias, Kemper, Gudrun, Budach, Volker, Denkert, Carsten, Gerber, Bernd, Tesch, Hans, Hirsmüller, Susanne, Sinn, Hans-Peter, Dunst, Jürgen, Münstedt, Karsten, Bick, Ulrich, Fallenberg, Eva, Tholen, Reina, Hung, Roswita, Baumann, Freerk, Beckmann, Matthias W, Blohmer, Jens, Fasching, Peter, Lux, Michael P, Harbeck, Nadia, Hadji, Peyman, Hauner, Hans, Heywang-Köbrunner, Sylvia, Huober, Jens, Hübner, Jutta, Jackisch, Christian, Loibl, Sibylle, Lück, Hans-Jürgen, von Minckwitz, Gunter, Möbus, Volker, Müller, Volkmar, Nöthlings, Ute, Schmidt, Marcus, Schmutzler, Rita, Schneeweiss, Andreas, Schütz, Florian, Stickeler, Elmar, Thomssen, Christoph, Untch, Michael, Wesselmann, Simone, Bücker, Arno, Buck, Andreas, and Stangl, Stephanie

Subjects
Medizin
Published
2018

34. Anastrozole versus tamoxifen for the prevention of locoregional and contralateral breast cancer in postmenopausal women with locally excised ductal carcinoma in situ (IBIS-II DCIS): A double-blind, randomised controlled trial

Author

Forbes, John F, Sestak, Ivana, Howell, Anthony, Bonanni, Bernardo, Bundred, Nigel, Levy, Christelle, von Minckwitz, Gunter, Eiermann, Wolfgang, Neven, Patrick, Stierer, Michael, Holcombe, Chris, Coleman, Robert E, Jones, Louise, Ellis, Ian, Cuzick, Jack, Sainsbury, Richard, Garber, Judy, Warwick, Jane, Buchanan, Mary, Buser, Katharina, Cawthorn, Simon, Coleman, Robert, Dowsett, Mitch, Eastell, Richard, Ejlertsen, Bent, Forbes, John, Kahan, Zsuzsanna, Baclesse, François, Mansel, Robert, Palva, Tiina, Rydén, Lisa, Stuart, Mary, Vaz, Fatima, Marsiglia, Hugo, Benyoucef, Ahmed, Berton-Rigaud, Dominique, Loustalot, Catherine, Serin, Daniel, Kerbrat, Pierre, Eymard, Jean-Christophe, Giard-Lefevre, Sylvia, Bonichon-Lamichhane, Nathalie, Monnier, Alain, Tubiana-Mathieu, Nicole, Piot, Gilles, de Lara, Christine Tunon, Bernard, Olivier, Simon-Swirski, Hélène, Gladieff, Laurence, Regaud, I Claudius, Fouchet-Goudier, Marie-Joseph, Dohollou, Nadine, Aquitaine, Nord, Elgard-Maitre, Anne-Marie, Bergerat, Jean-Pierre, Petit, Thierry, Marti, Adina, Toussaint, Caroline, Del Piano, Francesco, Ibrahim, Mahmoud, Fric, Danièle, Hönig, Arnd, Müller, Volkmar, Marmé, Frederik, Rautenberg, Beate, Schmidt, Marcus, Hanusch, Claus, Paepke, Stefan, Kaltenecker, Gabriele, Lemster, Sabine, Tio, Joke, Reimer, Toralf, Schnappauf, Benjamin, Baumann, Klaus, Schrader, Iris, Mundhenke, Christoph, Liedtke, Cornelia, Meinerz, Wolfgang, Thomssen, Christoph, Christl, Klaus, Hitschold, Thomas, Goerke, Kay, Kast, Karin, Runnebaum, Ingo, Lindner, Christoph, Scheidel, Peter, Herwig, Uwe, Bangemann, Nikola, Sommer, Harald, Göhring, Kornelia, Tulusan, Augustinus, Stauß, Eva, Köhler, Günter, Zahm, Dirk, Augustin, Doris, Hocke, Andrea, Neunhöffer, Tanja, Schmatloch, Sabine, Heinrich, Georg, Groß, Sabine, Breitbach, G P, Scharl, Anton, Klare, Peter, Stefek, Andrea, Hoffmann, Gerald, Martignoni, Franca, Weiss, Erich, Emons, Günter, Tesch, Hans-Christian, Beckmann, Matthias, Schmutzler, Rita, Schütte, Martin, Aktas, Bahriye, Hille-Betz, Ursula, Deryal, Mustafa, Dan Costa, Serban, Blümel, Beate, Göhring, Uwe-Jochen, Kleine-Tebbe, Anke, Schumacher, Claudia, Jasmin, Pourfard, Christoph, Uleer, Kullmer, Uwe, Krabisch, Petra, Gätje, Regine, Schwenzer, Thomas, Hindenburg, Hans-Joachim, Rempen, Andreas, Höffkes, Heinz-Gert, Stickeler, Elmar, Reffert, Christian, Seitz, Stephan, Splitt, Gerd, Böhne, Petra, Gnauert, Karsten, Strittmatter, Hans-Joachim, Baake, Gerold, Rezai, Mahdi, Noesselt, Thomas, Köhne, C-H, Hanf, Volker, Strumberg, Dirk, Dall, Peter, Schleicher, Peter, Schleicher, Bernd, Beldermann, Frank, Berghorn, Michael, Baerens, Dirk-Thoralf, Kolberg, Hans-Christian, Bauer, Lelia, Brucker, Cosima, Steck, Thomas, Boyle, Frances, Chaudhuri, Anupam, Wagga, Wagga, Moylan, Eugene, Donovan, Jenny, Della-Fiorentina, Stephen, Abdi, Ehtesham, Marx, Gavin, Beadle, Geoffrey, Donovan, Michael, Bennett, Ian, Gill, Peter Grantley, Baker, Caroline, Masters, Richard, Blum, Robert, Collins, John, Law, Michael, Hart, Stewart, Kannourakis, George, Snyder, Raymond, Joseph, David, McCrystal, Michael, Campbell, Ian, Jakesz, Raimund, Selim, Ursula, Singer, Christian, Heck, Dietmar, Greil, Richard, Ramoni, Angela, Bjelic-Radisic, Vesna, Reichenauer, Arno, Horvath, Wilfried, Thaler, Josef, Fridrik, Michael, Keckstein, Joerg, Jan, Lamote, L'Hermitte, Marc, Roelstrate, Heidi, Dirix, Luc, Bambust, Inneke, Seret, Monique, Liebens, Fabienne, Maerevoet, Maria, D'Hondt, Lionel, Berliere, Martine, Nogaret, Jean-Marie, Simon, Phillipe, O'Hanlon, Deirdre, Redmond, Henry Paul, Hill, Arnold, Evoy, Denis, Kerin, Michael, Gupta, Rajnish, Martin, Michael J, Fritis, Marcela, Schwartz, Ricardo, Yañez, Maria Loreto, Peralta, Octavio, Graiff, Claudio, Artioli, Fabrizio, Generali, Daniele, Orzalesi, Lorenzo, Visini, Marilena, Michiara, Maria, Pavesi, Lorenzo, Ravaioli, Alberto, Porpiglia, Mauro, Puglisi, Fabio, Pinotti, Graziella, Brincat, Stephen, Buser, Katharina S, Rabaglio, Manuela, Rauch, Daniel, Chappuis, Pierre O, Zaman, Khalil, Bucher, Susanne, Bolliger, Barbara, Pagani, Olivia, Falck, Anna-Karin, Kaij, Jakob, Margolin, Sara, Muslumanoglum, Mahmut, Bertelli, Gianfilippo, Bramley, Maria, Bristol, James, Chandrasekharan, Sankaran, Crellin, Perric, Daoud, Raouf, Dodwell, David, Drew, Philip, Dubey, Sidharth, Evans, Abigail, Ferguson, Douglas, Gendy, Raafat, Hamed, Hisham, Harding-McKean, Claudia, Horgan, Kieran, Iqbal, Shabana, Jibril, Jibril A, Kokan, Jalal, Kneeshaw, Peter, Lansdown, Mark, Lennard, Tom, Linforth, Rick, McIntosh, Stuart, Mitra, Sankha, Neades, Glyn, Ooi, Jane Louise, Patel, Ashraf, Rayter, Zenon, Reichert, Robert, Roberts, Fiona, Roche, Nicola, Rogers, Colin, Royle, Gavin, Shah, Elizabeth, Sibbering, Mark, Skene, Anthony Iain, Smith, Simon, Sparrow, Geoffrey, Thompson, Alastair, Vaidya, Jayant, Wolstenholme, Virginia, Wood, Jeremy, Yiangou, Constantinos, Zammit, Charles, Thornton, Rochelle, Probert, Flonda, Fong, Akiko, Francis, Nicole, Gili, Manuela, Eigenberger, Rosita, Supply, Daisy, Lefever, Inge, Muller, Bettina, Zlatar, Zdenka, Feer, Petra, Gkantiragas, Ioannis, Virkki, Marjo, Everhard, Sibille, Lemonnier, Jerome, Garcia, Sara, Ghanem, Saliha, Cole, Anna, O'Hare, Debra, Cronin, Elaine, Roche, Trudi, Kennedy, Emer, Ballot, Jo, Killilea, Niamh, Jennings, Marian, Lowry, Laura, Maxwell, Moira, Burke, Margaret, Gonzaga, Aliana Guerrieri, Bollani, Giorgia, Bianchetti, Andrea, Scalvini, Anna, Cretella, Elisabetta, Pasqualini, Antonella, Gobbi, Angela, Roselli, Jenny, Lagati, Angelita, Rapacchi, Elena, Lanza, Annalisa, Pini, Emanuela, Picardo, Elisa, Maggiorotto, Furio, Sottile, Roberta, Vallini, Ilaria, Cilia, Nadia, Patel, Mital, Bamford, Linda, Robertshaw, Helen, Inman, Hayle, Hill, Naomi, Dexter, Jane, Peasgood, Emily, Batty, Imogen, Cocks, Shirley, Mistry, Raksha, Sidders, Mary, Foulstone, Emily, Garlicka, Helen, Dawe, Catherine, Elliott, Jackie, Rooke, Kathy, Morris, Christine, Lester, Yvonne, Gibson, Sian, Chittock, Jill, Skelton, Amy, Gallimore, Elizabeth, Downes, Charlotte, Billett, Lynn, Caddy, Simone, Cumming, Helen, Cowell-Smith, Sharon, Turner, Caroline, Fernando, Sunjalee, Goodwin, Sarah, Taylor, Jo-Anne, Baines, Kizzy, Downer, Susan, Pilcher, Alice, Dobson, Tracey, Osborne, Lynn, Kuenzig, Greg, Hancock, Denise, Melia, Deborah, Gullaksen, Elaine, Hartup, Susan, Henson, Amy, Gibb, Jane, Coombs, Sarah, Taylor, Caroline, Kirkby, Amy, Thomas, Issy, Makinson, Karen, Kano, Yukie, Shah, Zoheb, Hardstaff, Lisa, Townley, Barbara, Hill, Philippa, McCurrie, Marilyn, Grassby, Sue, Henderson, Pamela, Talbot, Elizabeth, Bell, Ashley, Kanani, Reshma, Johnson, Joanne, Jones, Richard, Foster, Mel, Troke, Becky, Congdon, Hilary, Pascoe, Julie, Whelan, Sian, Edwards, Jenna, Brinkworth, Elaine, Blizard, Sheila, Clarke, Alison, Stevens, Kim, Harvey, Carol, Stacey, Jill, Mitchell, Sadie, Lowry, Tracey, Buckley, Sarah, Collins, Clare, Green, Liz, Jones, Helen, Conteh, Veronica, Ducket, Tracey, Kotze, Michelle, Strider, Paula, Stouraitis, Marina, Sundberg, Jan, Babiker, Abdel, Collins, Rory, Klijn, Jan, Ralston, Stuart, Tattersall, Martin, Weller, Ian, De Sousa, Andreia, Edwards, Rob, Ferguson, Sheila, Hickman, Jane, Johnson, Damian, Haidar, Nadia, Hammond, Victoria, Heighway, Emma, Ndoutoumou, Amalia, Sahota, Navdip, White, Laura, Aigret, Benoit, Batra, Priyanka, Knox, Jill, Oke, Adedayo, Ostler, Richard, and Sasieni, Peter

Subjects
Medicine (all), Medizin, skin and connective tissue diseases
Abstract

Third-generation aromatase inhibitors are more effective than tamoxifen for preventing recurrence in postmenopausal women with hormone-receptor-positive invasive breast cancer. However, it is not known whether anastrozole is more effective than tamoxifen for women with hormone-receptor-positive ductal carcinoma in situ (DCIS). Here, we compare the efficacy of anastrozole with that of tamoxifen in postmenopausal women with hormone-receptor-positive DCIS.In a double-blind, multicentre, randomised placebo-controlled trial, we recruited women who had been diagnosed with locally excised, hormone-receptor-positive DCIS. Eligible women were randomly assigned in a 1:1 ratio by central computer allocation to receive 1 mg oral anastrozole or 20 mg oral tamoxifen every day for 5 years. Randomisation was stratified by major centre or hub and was done in blocks (six, eight, or ten). All trial personnel, participants, and clinicians were masked to treatment allocation and only the trial statistician had access to treatment allocation. The primary endpoint was all recurrence, including recurrent DCIS and new contralateral tumours. All analyses were done on a modified intention-to-treat basis (in all women who were randomised and did not revoke consent for their data to be included) and proportional hazard models were used to compute hazard ratios and corresponding confidence intervals. This trial is registered at the ISRCTN registry, number ISRCTN37546358.Between March 3, 2003, and Feb 8, 2012, we enrolled 2980 postmenopausal women from 236 centres in 14 countries and randomly assigned them to receive anastrozole (1449 analysed) or tamoxifen (1489 analysed). Median follow-up was 7·2 years (IQR 5·6-8·9), and 144 breast cancer recurrences were recorded. We noted no statistically significant difference in overall recurrence (67 recurrences for anastrozole vs 77 for tamoxifen; HR 0·89 [95% CI 0·64-1·23]). The non-inferiority of anastrozole was established (upper 95% CI

Published
2016

35. 14th St. Gallen International Breast Cancer Conference 2015: Evidence, Controversies, Consensus - Primary Therapy of Early Breast Cancer: Opinions Expressed by German Experts

Author

Jakisch, Christian, Harbeck, Nadja, Huober, Jens, Minckwitz von, Gunter, Gerber, Bernd, Kreipe, Hans-Heinrich, Liedtke, Cornelia, Marschner, Norbert, Möbus, Volker, Scheithauer, Heike, Schneeweis, Andreas, Thomssen, Christoph, Loibl, Sibylle, Beckmann, Matthias W., Blohmer, Jens-Uwe, Costa, Serban-Dan, Decker, Thomas, Scharl, Anton, Diel, Ingo, Fasching, Peter A., Fehm, Tanja, Janni, Wolfgang, Lück, Hans-Joachim, Maass, Nicolai, and Untch, Michael

Subjects
ddc:618, Medizinische Fakultät, education
Abstract

The key topics of this year's 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 Gynäkologische 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.

Published
2015

36. Sentinel Lymph Node Biopsy in Breast Cancer Patients by Means of Indocyanine Green Using the Karl Storz VITOM® Fluorescence Camera.

Author

Papathemelis, Thomas, Jablonski, Evi, Scharl, Anton, Hauzenberger, Tanja, Gerken, Michael, Klinkhammer-Schalke, Monika, Hipp, Matthias, and Scharl, Sophia

Subjects
BREAST tumors, CANCER patients, MICROSURGERY, RADIOISOTOPES, TECHNETIUM, INDOLE compounds, SENTINEL lymph node biopsy
Abstract

Currently, the use of radioisotope and blue dye for sentinel lymph node biopsy (SLNB) for axillary staging in breast cancer is common. Recently, indocyanine green (ICG) has been proposed as an alternative sentinel lymph node (SLN) tracking agent. We evaluated the clinical value of ICG as an additional tracer in combination with Technetium99m and as an alternative to Technetium99m for the identification of SLN in 104 breast cancer patients. 21 patients had at least 1 histologically tumor-positive SLN. All 21 patients were detected by ICG; in one of these 21 sentinel-positive patients, Technetium99m was unable to identify lymph node involvement. Our results show that ICG is as effective as the radioisotope for SLNB. In addition, as a near-infrared dye, it has the advantages of real-time visualization, lower cost, and wider availability, since no radioactive material needs to be handled. This trial is registered with German Clinical Trial Register Main ID: DRKS00013606. [ABSTRACT FROM AUTHOR]

Published
2018
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38. Shifting cancer care towards Multidisciplinarity: the cancer center certification program of the German cancer society.

Author

Kowalski, Christoph, Graeven, Ullrich, von Kalle, Christof, Hauke Lang, Beckmann, Matthias W., Blohmer, Jens-Uwe, Burchardt, Martin, Ehrenfeld, Michael, Fichtner, Jan, Grabbe, Stephan, Hoffmann, Hans, Iro, Heinrich, Post, Stefan, Scharl, Anton, Schlegel, Uwe, Seufferlein, Thomas, Stummer, Walter, Ukena, Dieter, Ferencz, Julia, and Wesselmann, Simone

Subjects
CANCER prevention, MEDICAL quality control, COLON cancer, BREAST cancer, GERMANS, DISEASES
Abstract

Background: Over the last decades numerous initiatives have been set up that aim at translating the best available medical knowledge and treatment into clinical practice. The inherent complexity of the programs and discrepancies in the terminology used make it difficult to appreciate each of them distinctly and compare their specific strengths and weaknesses. To allow comparison and stimulate dialogue between different programs, we in this paper provide an overview of the German Cancer Society certification program for multidisciplinary cancer centers that was established in 2003.Main Body: In the early 2000s the German Cancer Society assessed the available information on quality of cancer care in Germany and concluded that there was a definite need for a comprehensive, transparent and evidence-based system of quality assessment and control. This prompted the development and implementation of a voluntary cancer center certification program that was promoted by scientific societies, health-care providers, and patient advocacy groups and based on guidelines of the highest quality level (S3). The certification system structures the entire process of care from prevention to screening and multidisciplinary treatment of cancer and places multidisciplinary teams at the heart of this program. Within each network of providers, the quality of care is documented using tumor-specific quality indicators. The system started with breast cancer centers in 2003 and colorectal cancer centers in 2006. In 2017, certification systems are established for the majority of cancers. Here we describe the rationale behind the certification program, its history, the development of the certification requirements, the process of data collection, and the certification process as an example for the successful implementation of a voluntary but powerful system to ensure and improve quality of cancer care.Conclusion: Since 2003, over 1 million patients had their primary tumors treated in a certified center. There are now over 1200 sites for different tumor entities in four countries that have been certified in accordance with the program and transparently report their results from multidisciplinary treatment for a substantial proportion of cancers. This led to a fundamental change in the structure of cancer care in Germany and neighboring countries within one decade. [ABSTRACT FROM AUTHOR]

Published
2017
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39. Intracellular actions of steroid hormones and their therapeutic value, including the potential of radiohalosteroids against ovarian cancer.

Author

Holt, John A., Scharl, Anton, Kullander, Stig, and Beckmann, Matthias W.

Subjects
*OVARIAN cancer, *STEROID hormones, *CARCINOGENS, *ONCOLOGY, *HORMONE antagonists
Abstract

The biological activities of steroid hormones are effected via intracellular receptors. The receptors are part of a ligand-activated family of transcription regulator proteins that are critical for steroid-regulated cell differentiation. With recombinant cDNA technology, yeast and cultured animal cells can be made to express mammalian cDNA steroid receptors from cDNA clones that contain deletions and substitutions. Among the leading problems addressed in these models is the characterization of sequences that promote association or interaction with other transcription regulating molecules, including oncogene products. Recently it has been found that heat shock proteins may serve not only to stabilize the receptor proteins but also to precondition the activation imparted by ligand binding. Aberrant receptor proteins can be found in ovarian cancer. Whether aberrant receptor proteins are associated with transformation in general or with a variable clinical response to steroidal or anti-steroidal therapy is not known. Even after chemotherapy, steroid receptors are expressed in the metastases of ovarian cancers seen clinically, and they may have potential uses for localization and treatment of receptor-rich cancers. Radioligand pharmaceuticals appropriate for imaging or for site-directed radiocytotoxicity can be sequestered to the nuclei of receptor-rich cancers. Initial clinical imaging and therapy trials with such pharmaceuticals have been approved and begun. In the use of halogenated estrogen radiopharmaceuticals, liver metabolism and enterohepatic recirculation are important considerations. Ascites prolongs retention of a radiohalogenated estrogen in the abdominal cavity. Distant metastases have been localized with [l23I]-estrogen in breast cancer patients in pre-operative procedures. Receptor-mediated cytotoxicity occurs when estrogen receptor radioligand pharmaceuticals that are Auger electron emitters are used in vitro. [ABSTRACT FROM AUTHOR]

Published
2017
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42. Second International Consensus Conference on Advanced Breast Cancer (ABC2), Lisbon, 11/09/2013: The German Perspective.

Author

Harbeck, Nadia, Marschner, Norbert, Untch, Michael, Decker, Thomas, Hegewisch-Becker, Susanna, Jackisch, Christian, Huober, Jens, Lück, Hans-Joachim, von Minckwitz, Gunter, Scharl, Anton, Schneeweiss, Andreas, Tesch, Hans, Welt, Anja, Wuerstlein, Rachel, and Thomssen, Christoph

Subjects
CONFERENCES & conventions, BREAST tumors, METASTASIS
Abstract

The Advanced Breast Cancer Second International Consensus Conference (ABC2) on diagnosis and treatment of advanced breast cancer took place in Lisbon, Portugal, on November 7-9, 2013. The focus of the conference was inoperable, locally advanced breast cancer. The diagnosis and treatment of metastatic breast cancer had already been discussed 2 years before at the ABC1 Consensus and were only updated regarding special issues as part of this year's ABC2 Consensus. Like 2 years ago, a working group of German breast cancer experts commented on the voting results of the ABC panelists, with special consideration of the German guidelines for the diagnosis and treatment of breast cancer (German Gynecological Oncology Working Group (AGO) recommendations, S3 Guideline) in order to adapt them for daily clinical practice in Germany. The goal of both the ABC Consensus and the German comments is to facilitate evidence-based therapy decisions. © 2014 S. Karger GmbH, Freiburg [ABSTRACT FROM AUTHOR]

Published
2014
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45. AGO Recommendations for Diagnosis and Treatment of Patients with Early and Metastatic Breast Cancer: Update 2012.

Author

Scharl, Anton, Thomssen, Christoph, and Harbeck, Nadia

Subjects
BREAST tumor diagnosis, BREAST tumor treatment, METASTASIS, CANCER treatment, AGE distribution, MAMMOGRAMS, CANCER patient medical care, MEDICAL protocols, WOMEN'S health, EARLY medical intervention, DIAGNOSIS
Abstract

The article discusses evidence-based recommendations for the diagnosis of patients with early breast cancer and metastatic breast cancer which have been released by the Breast Committee of the Arbeitsgemeinschaft Gynäkologische Onkologie (German Gynecological Oncology Group, AGO)on an annual basis since 2001. Updates on the guidelines which the committee released in 2012 are discussed.

Published
2012
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46. ABC1 Consensus Conference - a German Perspective.

Author

Thomssen, Christoph, Marschner, Norbert, Untch, Michael, Decker, Thomas, Hegewisch-Becker, Susanna, Jackisch, Christian, Janni, Wolfgang, Lück, Hans-Joachim, von Minckwitz, Gunter, Scharl, Anton, Schneeweiss, Andreas, Tesch, Hans, Welt, Anja, and Harbeck, Nadia

Subjects
BREAST tumor diagnosis, METASTASIS, CANCER treatment, CONFERENCES & conventions, BIOMARKERS, BIOPSY, BREAST tumors, CANCER chemotherapy, DIAGNOSTIC imaging, TUMOR classification, WOMEN'S health, DISEASE management
Abstract

A group of German breast cancer experts (medical oncologists and gynaecologists) reviewed and commented on the results of the first international 'Advanced Breast Cancer First Consensus Conference' (ABC1) for the diagnosis and treatment of advanced breast cancer. The ABC1 Conference is an initiative of the European School of Oncology (ESO) Metastatic Breast Cancer Task Force in cooperation with the EBCC (European Breast Cancer Conference), ESMO (European Society of Medical Oncology) and the American JNCI (Journal of the National Cancer Institute). The main focus of the ABC1 Conference was metastatic breast cancer (stage IV). The ABC1 consensus is based on the vote of 33 breast cancer experts from different countries and has been specified as a guideline for therapeutic practice by the German expert group. It is the objective of the ABC1 consensus as well as of the German comments to provide an internationally standardized and evidence-based foundation for qualified decision-making in the treatment of metastatic breast cancer. Copyright © 2012 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Published
2012
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47. AGO Recommendations for Diagnosis and Treatment of Patients with Primary and Metastatic Breast Cancer. Update 2011.

Author

Thomssen, Christoph, Scharl, Anton, and Harbeck, Nadia

Subjects
ONCOLOGY, BREAST tumor diagnosis, BREAST tumor treatment, METASTASIS, CANCER treatment, ANTINEOPLASTIC agents, CANCER chemotherapy, COMMITTEES, MEDICAL protocols, WOMEN'S health, EVIDENCE-based medicine, DIAGNOSIS
Abstract

The article focuses on propositions for diagnosis and treatment of patients with early and metastatic breast cancer. Details related to different types of therapy including adjuvant endocrine therapy, chemotherapy and neoadjuvant (primary) systemic therapy are discussed. Also included is information about the guidelines for patients published in an easy language for establishing communication between patients and doctors.

Published
2011
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48. Does Center Volume Correlate with Survival from Breast Cancer?

Author

Scharl, Anton and Göhring, Uwe-Jochen

Subjects
BREAST cancer surgery, MORTALITY, CANCER treatment, PHYSICIANS, SURGEONS
Abstract

With its high incidence and long history of patient advocacy, breast cancer has generated the most concern about the quality of its care and the volume-outcome relationship. In breast cancer surgery, the risk of perioperative morbidity or mortality is low, but surgery is only one single piece in the mosaic of multidisciplinary care that eventually determines survival. Only a limited number of articles is available investigating the relationship between case volume of physicians and hospitals and specialization of surgeons and survival. In summary, there is evidence to support the hypothesis that specialization, research interest, and caseload of physicians and hospitals is positively correlated with providing state-of-the-art care and with survival. However, it is less clear what impact might be attributed to the surgical routine gained with increasing number of procedures compared to the deeper insight into the biology of breast cancer that comes with specialization in oncology and the weight of the multidisciplinary setting that is more easily established and maintained with a higher caseload. Copyright © 2009 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Published
2009
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49. Adjuvant Antibody Therapy with Trastuzumab in Early Breast Cancer.

Author

Untch, Michael, Scharl, Anton, Jackisch, Christian, Thomssen, Christoph, Nitz, Ulrike, von Minckwitz, Gunter, and Harbeck, Nadia

Subjects
BREAST cancer, TRASTUZUMAB, IMMUNOTHERAPY, PROTO-oncogenes, ADJUVANT treatment of cancer
Abstract

Immunotherapy with the monoclonal antibody trastuzumab is a well established cornerstone of an individualized treatment strategy for women with HER2/neu-overexpressing breast cancer. Based on the reported data of clinical studies comprising more than 14,000 women, trastuzumab was approved throughout the European Union in May 2006 for adjuvant therapy in patients with early-stage HER2/neu-overexpressing breast cancer. [ABSTRACT FROM AUTHOR]

Published
2006
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