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Sarcomas of the extremities are rare entities, the treatment of which requires special expertise. Even if the treatment of patients is always interdisciplinary, the surgical R0 resection is the key point of each curatively intended treatment. In addition to resection in sano, the aim is to preserve the extremities and function, so that defect reconstruction after resection plays a decisive role. Due to the heterogeneity of tumors as well as their localization and extent, reconstruction is always an individually adapted treatment. Modular tumor endoprostheses are often used in this context, which can be constructed according to the size of the defect. The transplantation of autologous or allogeneic bone is also frequently used alone or as an additive procedure. Patient-specific (mega)prostheses are used particularly for pelvic tumors. Defect reconstruction using scaffold-based procedures from the field of tissue engineering is being tested as a promising procedure for the future. This article provides an overview of the treatment principles for sarcomas of the extremities and their individual reconstruction options. [ABSTRACT FROM AUTHOR]

The German Ethics Council has published recommendations for the ethically responsible use of Artificial Intelligence (AI) in medicine. The statement emphasizes the need for a comprehensive examination of the ethical aspects of AI and new technologies. Various applications of AI in medicine are presented, such as pattern recognition in cancer diagnosis and therapy chatbots. The authors emphasize the importance of evaluating the impact of AI on responsibility and human authorship. Various actors are mentioned who should be involved in the development and application process of AI systems, and the importance of data protection standards and clear regulations for data usage is highlighted. It is emphasized that the competence of doctors and personal care remain of great importance and that ethical standards must be adhered to in order to ensure the well-being of patients. [Extracted from the article]

Die Symposiumsreihe,,Vom Biomarker zur Therapie' der Trillium Akademie bietet einen Einblick in die moderne onkologische Präzisionsmedizin. Im Fokus der diesjährigen Veranstaltung, die wegen der Corona-Pandemie ausschließlich virtuell stattfand, standen neben,,Liquid Profiling' für die Früherkennung und Verlaufskontrolle auch die Digitalisierung der Analytik und das Zusammenspiel von Molekularpathologie und personalisierter Krebstherapie. Trotz der rasanten Entwicklungen finden sich derzeit nur für einen kleinen Teil der Patienten angreifbare Alterationen oder Marker, die sie für eine Immuntherapie qualifizieren. Doch auch in dieser Hinsicht wird die Individualisierung der Therapie weiter voranschreiten. [ABSTRACT FROM AUTHOR]

The article discusses the court case LG Kiel, judgment of 29.3.2019-8O190/16, rkr. wherein claim for doctor's liability on advising for alternative treatment instead of conventional medicine for breast cancer with lymph node metastases is questioned. It reports on cancer therapy, mammography and breast sonography.

The article offers an analysis of the benefits of HER2 targeted therapies for the prognosis of patients with HER2-positive breast cancer. It mentions those affected with low HER2 expression could also benefit from therapy with antibody-drug conjugates (ADCs). It also mentions HER2 overexpression or amplification occurs in various tumor entities, and is associated with more aggressive tumor growth and lower overall survival rates without appropriate targeted therapy.

The article reports on the administration of irreversible electroporation (IRE) in a patient with prostate carcinoma with a Gleason Score of 6. The Prof. Dr. S. Institute for Diagnostic Imaging uses irreversible electroporation, in which malignant tumor cells are to be destroyed with the help of ultrashort electrical pulses.

The article offers information on the CAR-T cell therapeutics launched by Paul-Ehrlich-Institut which has recently approved by the European Commission. Topics discussed include genetic modification of cells, medical researches conducted by the institute, its new cancer therapy and its therapies based on immune cells.

The article titled "Liability of the gynecologist and radiologist for delayed treatment initiation in case of breast cancer" deals with the case of a patient who died from liver failure due to liver metastases of breast cancer as a result of delayed treatment initiation. The gynecologist and radiologist were held liable for treatment and information errors. The gynecologist had read the radiologist's findings but did not inform the patient about the urgent need for further clarification. The radiologist had suggested that no further clarification was necessary, although the mammography examination showed abnormal results. The lower courts awarded compensation to the patient's children and established the liability of both doctors. [Extracted from the article]

Data are available on two multicenter observational studies, the East German Gastric Cancer Study (EGGCS) '02 (surgical interventions only) and the German Gastric Cancer Study II (QCGC) from 2007 to 2009 (after inauguration of multimodal therapeutic concepts) with regard to palliative treatment of advanced gastric cancer. Through the first investigation period from January to December 2002 (EGGCS) overall 1139 patients with primary gastric cancer were registered and evaluated and then from 2007 to 2009 (QCGC) another 2897 patients were included. Comparing both time periods, there were no significant changes in the distribution of tumor sites and stages according to the Union Internationale Contre le Cancer (UICC) classification, in particular, there was no significant reduction of advanced tumor stages. From 2007 to 2009 in total 521 patients (18 %) received neoadjuvant therapy, 401 patients (13.9 %) out of the group with curative intention and 120 (4.1 %) out of the group of patients with palliative intention. The proportion of palliative patients who underwent chemotherapy (with neoadjuvant intention and/or postoperatively) was 32.5 % (n = 223). Thus, the rate of palliative treatment (rate of no R0 resection status 29.6 %, rate of patients who did not undergo surgical intervention at all 9.5 %) could be diminished from almost 40 % in 2002 to 24.5 % through the time period from 2007 to 2009. Taking all patients together (with curative and palliative intention) an increase of the 4-year survival probability from 40.0 % to 48.5 % was observed after inauguration of multimodal therapy. After a 5-year follow-up median survival time was 34 months during the investigation period from 2007 to 2009 considering all study subjects. Patients who had undergone palliative surgical interventions benefited from postoperative palliative chemotherapy; however, as expected this was of greater benefit to patients with resecting surgical interventions than those with non-resecting operations. Palliative tumor resection (even R2 resection status) should be part of a concept of multimodal palliative therapy in cases of acceptable perioperative risk. [ABSTRACT FROM AUTHOR]

Tumor resection and trauma may leave devastating defects in the head and neck area complicating and preventing patient rehabilitation; therefore, plastic surgery methods are required which are able to prevent further complications and provide efficient functional and aesthetic reconstruction. In this review article typical cases and the interdisciplinary management of plastic surgery are presented. [ABSTRACT FROM AUTHOR]

The article "Melanomas: Preserving Resting Phase and Preventing Relapse" reports on a new research finding in the field of cancer therapy. Researchers have discovered a protein called KDM5B that plays a role in the resting phase of melanoma cells. By using a substance called Cpd1, the researchers were able to inhibit the flexibility of the cells and allow an additional cancer medication to fully take effect. This double-strike strategy could be a significant advancement in cancer therapy, but it still needs to be confirmed in clinical studies. [Extracted from the article]

Background: The development of modern videoendoscopy enables surgeons to perform laparoscopic resection of colonic cancer. Aim: This manuscript evaluated the literature concerning clinically relevant differences in the short and long-term course after laparoscopic or conventional resection of colonic cancer. Methods: An investigation of meta-analyses from randomized controlled clinical trials comparing laparoscopic and conventional surgery for colonic cancer was carried out. Results: The incidence of intraoperative complications was higher during laparoscopic surgery, the duration of surgery was increased and blood loss was less when compared to open surgery. Overall morbidity and the incidence of surgical complications were decreased after laparoscopic surgery. General morbidity and mortality were not different after laparoscopic or open resection of colonic cancer. Duration of hospital stay was shorter but was also associated with the type of perioperative care (i.e. traditional or enhanced recovery). Following minimally invasive or conventional resection, the incidence of tumor recurrence (local and distant) and the duration of survival (overall and disease-free) showed no differences. Wound implantations were rare after both operative techniques but with a tendency to occur more often after laparoscopic than open resection. Conclusion: Laparoscopic resection of colonic cancer has clinically relevant short-term benefits for the patients and long-term results are not different from open colectomy. However, most of the patients included in randomized controlled trials underwent right or left colectomy and sigmoid or rectosigmoid resections. Data with a high level of evidence concerning carcinomas of the flexures or the transverse colon do not exist. Suitable patients with colonic cancer should undergo laparoscopic resection by experienced surgeons. [ABSTRACT FROM AUTHOR]

Background: Innovative surgical techniques in colorectal surgery aim to provide diminished surgical injury and at least equivalent or even improved quality of treatment and oncological results. High level clinical studies are mandatory to examine the feasibility and advantages (or disadvantages) of new operative techniques. Objectives: Laparoscopic colonic resection for cancer has been investigated with respect to safety and oncological quality in various prospective randomized studies (COST study, COLOR-I and CLASICC). The minimally invasive procedure is feasible and safe which was demonstrated in many studies but can these results be extrapolated to laparoscopic rectal cancer surgery? Results: The short term outcomes of the COLOR-II trial were published recently and laparoscopic resection for rectal cancer was not found to be inferior compared to open resection. Recovery after laparoscopic surgery was better than after open surgery. Laparoscopic surgery was found to have significant advantages with respect to blood loss, operating time, use of pain medication, early restoration of bowel function and reduction of hospital stay as well as the lateral safety margins in the distal third of the rectum. The long-term results focussing on local recurrence showed a positive trend in favor of laparoscopic rectal surgery and will be published shortly. Conclusion: Laparoscopic total mesorectal excision (TME) appears to have clinically measurable short-term advantages in patients with primary rectal cancer based on the evidence of randomized studies. Laparoscopic rectal cancer resection may become the gold standard in the future. [ABSTRACT FROM AUTHOR]

Background: Prospective randomized studies and meta-analyses have shown that laparoscopic resection for colonic cancer is equivalent to open resection with respect to the oncological results and has short-term advantages in the early postoperative outcome. The aim of this study was to investigate whether laparoscopic colonic resection has become established as the standard in routine treatment. Methods: Data from the multicenter observational study 'Quality assurance colonic cancer (primary tumor)' from the time period from 1 January 2009 to 21 December 2011 were evaluated with respect to the total proportion of laparoscopic colonic cancer resections and tumor localization and specifically for laparoscopic sigmoid colon cancer resections. A comparison between low and high volume clinics (< 30 versus ≥ 30 colonic cancer resections/year) was carried out. Results: Laparoscopic colonic cancer resections were carried out in 12 % versus 21.4 % of low and high volume clinics, respectively (p < 0.001) with a significant increase for low volume clinics (from 8.0 % to 15.6 %, p < 0.001) and a constant proportion in high volume clinics (from 21.7 % to 21.1 %, p = 0.905). For sigmoid colon cancer laparoscopic resection was carried out in 49.7 % versus 47.6 % (p = 0.584). Differences were found between low volume and high volume clinics in the conversion rates (17.3 % versus 6.6 %, p < 0.001), the length of the resected portion (Ø 23.6 cm versus 36.0 cm, p < 0.001) and the lymph node yield (Ø n = 15.7 versus 18.2, p = 0.008). There were no differences between the two groups of clinics regarding postoperative morbidity and mortality. The postoperative morbidity and length of stay were significantly lower for laparoscopic sigmoid resection than for conventional sigmoid resection. Conclusion: The laparoscopic access route for colonic cancer resection is not the standard approach in the participating clinics. The laparoscopic access route has the highest proportion for sigmoid colon resection. The differences in the conversion rates, length of the resected portion and the number of lymph nodes investigated between the low volume and high volume clinics must be viewed critically and must be interpreted in connection with the long-term oncological results. [ABSTRACT FROM AUTHOR]

The current S3 guidelines on the surgical treatment of colorectal cancer note that with a suitable patient selection and expertise of the surgeon the same oncological results can be achieved laparoscopically as with the open procedure. This requires that the same quality requirements have to be provided for both methods. The most important quality parameters of right sided (extended) hemicolectomy are central ligation of the supplying arteries (ileocolic artery, right branch of the middle colic artery and middle colic artery) flush to the central origin of the vessel (superior mesenteric artery or middle colic artery) and the sharp dissection of the mesocolon without any preparation tears. The photographic documentation of the fresh surgical specimens for categorizing the preparation quality as well as to determine the pedicle of the vessel can capture this quality well and is also currently the best surrogate parameter to evaluate the oncological quality of the operation. At present, there are still considerable widespread deficits not only with the laparoscopic approach but also in open surgery which must be urgently fixed. [ABSTRACT FROM AUTHOR]

Präzisionsonkologie steht für moderne, individualisierte Tumortherapie. Die Erstellung molekularer Tumorprofile auf Basis softwaregestützter Genvariantenanalysen ermöglicht präzisere Diagnosen, bessere Therapieinformationen und damit eine optimierte Versorgung der Krebspatienten. Molekulare Diagnostik als Basis zielgerichteter und immunonkologischer Therapien hat inzwischen in vielen Indikationen Einzug in die medizinischen Leitlinien gefunden und den Einsatz verfügbarer Therapien auch bei seltenen Tumoren erheblich erweitert. [ABSTRACT FROM AUTHOR]

The article presents a report on colon cancer which is known as the most common cancers in Germany. It states that since the introduction of screening colonoscopy in 2002, doctors have shown some hope for its treatment. It also states that there are more targeted approval antibody therapies available against the growth factor receptor EGFR.

The article focuses on the compliance of testing of non-small cell lung cancer (NSCLC) with cancer treatment guidelines. It discusses a survey conducted by professor Helmut Ostermann on test behavior of doctors and oncological practices or medical care centers. It also presents views of Ostermann on therapy of NSCLC patients at the Cancer Congress held on February 20, 2020 in Berlin, Germany.

The article reports on the treatment of various cancers through the therapy of immune checkpoint inhibition.