@article{HornFischerRaptisetal., author = {Horn, Lars-Christian and Fischer, Uta and Raptis, Georgios and Bilek, Karin and Hentschel, Bettina and Richter, Christine E. and Braumann, Ulf Dietrich and Einenkel, Jens}, title = {Pattern of invasion is of prognostic value in surgically treated cervical cancer patients}, series = {Gynecologic Oncology}, volume = {103}, journal = {Gynecologic Oncology}, number = {3}, doi = {10.1016/j.ygyno.2006.05.046}, pages = {906 -- 911}, abstract = {Objectives: Different patterns of invasion (representing different grades of tumor cell dissociation) are associated with prognostic outcome in cancer. We evaluated the prognostic value of different patterns of invasion (PI) in cervical carcinomas (CX). Methods: Six hundred eleven surgically treated CX (FIGO IB to IIB) were re-evaluated histologically regarding the PI, using a three-level scoring system. Closed PI was defined as cohesive growth with well-delineated (pushing) borders. In finger-like PI the tumor grows in solid cords/trabecles. Highly dissociative growth in small groups or single cells was defined as spray-like PI. Types of PI were correlated to tumor stage, histo-morphologic factors and prognostic outcome. Results: Sixty percent of the tumors showed a spray-like PI, 30\% a finger-like PI and only 7.4\% were of the closed type. Spray-like PI showed a significant correlation with advanced stage disease, lymphovascular space involvement, poorly differentiated tumors and pelvic lymph node metastases. Spray-like PI was accompanied by a reduced 5-year overall survival when compared to the finger-like and closed PI (68.7\% vs. 80.9\% vs. 88.5\%; P=0.0004). The prognostic impact of the PI disappeared in node-positive patients (P=0.06) but persisted in patients without pelvic lymph node disease (P=0.03). In multivariate analysis, using COX regression model, the PI represented as independent prognostic factor. Conclusions: Spray-like PI (i.e., highest degree of tumor cell dissociation) is associated with advanced tumor stages, increased rate of recurrency and a reduced overall survival. In separate analysis of patients with and without lymph node metastases, the impact of PI persisted only in node-negative cases as a prognostic factor.}, subject = {Geb{\"a}rmutterhalskrebs}, language = {en} } @article{HornRaptisFischeretal., author = {Horn, Lars-Christian and Raptis, Georgios and Fischer, Uta and Bilek, Karin}, title = {Standardised handling of hysterectomy specimen in cervical cancer - report of over 900 stage pT1b1- to pT2b-tumors}, series = {Pathology - Research and Practice}, volume = {196}, journal = {Pathology - Research and Practice}, pages = {450}, subject = {Geb{\"a}rmutterhalskrebs}, language = {en} } @article{HornFischerRaptisetal., author = {Horn, Lars-Christian and Fischer, Uta and Raptis, Georgios and Bilek, Karin and Hentschel, Bettina}, title = {Tumor size is of prognostic value in surgically treated FIGO stage II cervical cancer}, series = {Gynecologic Oncology}, volume = {107}, journal = {Gynecologic Oncology}, number = {2}, doi = {10.1016/j.ygyno.2007.06.026}, pages = {310 -- 315}, abstract = {Objectives Tumor size is a well recognized prognostic factor in early stage cervical carcinoma (CX). However, limited knowledge exists about the value of tumor size in surgically treated CX with extrauterine extension. Methods 245 cases of local advanced CX (FIGO stage IIA and IIB) who received upfront surgery were evaluated regarding tumor size, regarding the prediction of pelvic lymph node involvement and recurrence free and overall survival during a median follow-up time of 54 months (95\% CI 45.4-62.6 months). Tumors larger than 4 cm were defined as bulky stage disease. Results Bulky disease was seen in 46.1\% (113/245). 60.2\% of these patients showed pelvic lymph node involvement, compared to 42.4\% (56/132) in non-bulky tumors (p = 0.006; odds ratio: 2.2 [95\% CI: 1.3-3.6]). Patients with bulky tumors showed an increase of recurrent disease (40.2\% vs. 28.0\%; p = 0.045). The relative risk for recurrent disease was 1.97 (95\% CI: 1.3-3.0). The 5-year overall survival rate was significantly lower (67.7\% [95\% CI: 58.2-74.8] vs. 49.5\% [95\% CI: 36.8-59.1]; p = 0.0015). In multivariate analysis, tumor stage, pelvic lymph node involvement and maximal tumor size were independent prognostic factors. Conclusions The results suggest that tumor size, defining bulky disease as tumors larger than 4 cm, is of prognostic impact also in FIGO stage II cervical carcinomas. A revised FIGO/TNM classification system similar to the subgrouping of stage IB CX is recommended for stage II using a cut-off value of 4 cm as discriminator: stage IIA1 and stage IIB1 for tumors with ≤ 4 cm and IIA2 and IIB2 for tumors > 4 cm (i.e. bulky disease).}, subject = {Geb{\"a}rmutterhalskrebs}, language = {en} } @article{HornRaptisFischeretal., author = {Horn, Lars-Christian and Raptis, Georgios and Fischer, Uta and Bilek, Karin}, title = {Impact of tumorload in surgically treated, histologically staged early cervical cancer: Multivariate analysis of 568 patients}, series = {International Journal of Gynecology \& Obstetrics}, volume = {70}, journal = {International Journal of Gynecology \& Obstetrics}, number = {Suppl. 1}, pages = {20 -- 21}, subject = {Geb{\"a}rmutterhalskrebs}, language = {en} } @article{HornRaptisFischeretal., author = {Horn, Lars-Christian and Raptis, Georgios and Fischer, Uta and Bilek, Karin}, title = {p53-tumorsuppressor gene in surgically treated histologically staged early cervical cancer}, series = {International Journal of Gynecology \& Obstetrics}, volume = {70}, journal = {International Journal of Gynecology \& Obstetrics}, number = {Suppl. 1}, pages = {112}, subject = {Tumorsuppressor-Gen}, language = {en} } @article{HornFischerHaneletal., author = {Horn, Lars-Christian and Fischer, Uta and Hanel, C. and Kuhn, H. and Raptis, Georgios and Bilek, Karin}, title = {p53 in surgically treated and pathologically staged cervical cancer}, series = {Pathology - Research and Practice}, volume = {197}, journal = {Pathology - Research and Practice}, number = {9}, pages = {605 -- 609}, subject = {Geb{\"a}rmutterhalskrebs}, language = {en} } @article{FischerRaptisGessneretal., author = {Fischer, Uta and Raptis, Georgios and Geßner, W. and Roschlau, U. and Dressel, K. and Bilek, Karin and Horn, Lars-Christian}, title = {Epidemiologie und formale Pathogenese des Zervixkarzinoms}, series = {Zentralblatt f{\"u}r Gyn{\"a}kologie}, volume = {123}, journal = {Zentralblatt f{\"u}r Gyn{\"a}kologie}, number = {4}, pages = {198 -- 205}, subject = {Geb{\"a}rmutterhalskrebs}, language = {de} }