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  • 1
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    Online Resource
    Sarcoma of the Uterus. Guideline of the DGGG, OEGGG and SGGG (S2k-Level, AWMF Registry No. 015/074, April 2021)
    Georg Thieme Verlag KG ; 2022
    In:  Geburtshilfe und Frauenheilkunde Vol. 82, No. 12 ( 2022-12), p. 1337-1367
    Details
    In: Geburtshilfe und Frauenheilkunde, Georg Thieme Verlag KG, Vol. 82, No. 12 ( 2022-12), p. 1337-1367
    Abstract: Purpose This is an official guideline, published and coordinated by the Germany Society for Gynecology and Obstetrics (Deutsche Gesellschaft für Gynäkologie und Geburtshilfe, DGGG). Because of their rarity and heterogeneous histopathology, uterine sarcomas are challenging in terms of their clinical management and therefore require a multidisciplinary approach. To our knowledge, there are currently no binding evidence-based recommendations for the appropriate management of this heterogeneous group of tumors. Methods This S2k guideline was first published in 2015. The update published here is once again the result of the consensus of a representative interdisciplinary committee of experts who were commissioned by the Guidelines Committee of the DGGG to carry out a systematic search of the literature on uterine sarcomas. Members of the participating professional societies achieved a formal consensus after a structured consensus process. Recommendations 1.1 Epidemiology, classification, staging of uterine sarcomas. 1.2 Symptoms, general diagnostic workup, general pathology or genetic predisposition to uterine sarcomas. 2. Management of leiomyosarcomas. 3. Management of low-grade endometrial stromal sarcomas. 4. Management of high-grade endometrial stromal sarcoma and undifferentiated uterine sarcomas. 5. Management of adenosarcomas. 6. Rhabdomyosarcomas of the uterus in children and adolescents. 7. Follow-up of uterine sarcomas. 8. Management of morcellated uterine sarcomas. 9. Information provided to patients.
    Type of Medium: Online Resource
    ISSN: 0016-5751 , 1438-8804
    URL: Article
    DOI: 10.1055/a-1897-5124
    Language: English
    Publisher: Georg Thieme Verlag KG
    Publication Date: 2022
    detail.hit.zdb_id: 2026496-3
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  • 2
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    EURO-B.O.S.S.: A European study on chemotherapy in bone-sarcoma patients aged over 40: Outcome in primary high-grade osteosarcoma
    SAGE Publications ; 2018
    In:  Tumori Journal Vol. 104, No. 1 ( 2018-01), p. 30-36
    Details
    In: Tumori Journal, SAGE Publications, Vol. 104, No. 1 ( 2018-01), p. 30-36
    Abstract: The EUROpean Bone Over 40 Sarcoma Study (EURO-B.O.S.S.) was the first prospective international study for patients 41-65 years old with high-grade bone sarcoma treated with an intensive chemotherapy regimen derived from protocols for younger patients with high-grade skeletal osteosarcoma. Methods: Chemotherapy based on doxorubicin, cisplatin, ifosfamide, and methotrexate was suggested, but patients treated with other regimens at the investigators’ choice were also eligible for the study. Results: The present report focuses on the subgroup of 218 patients with primary high-grade osteosarcoma. With a median follow-up of 47 months, the 5-year probability of overall survival (OS) was 66% in patients with localized disease and 22% in case of synchronous metastases. The 5-year OS in patients with localized disease was 29% in pelvic tumors, and 70% and 73% for extremity or craniofacial locations, respectively. In primary chemotherapy, tumor necrosis ≥90% was reported in 21% of the patients. There were no toxic deaths; however, hematological toxicity was considerable with 32% of patients experiencing 1 or more episodes of neutropenic fever. The incidence of nephrotoxicity and neurotoxicity (mainly peripheral) was 28% and 24%, respectively. After methotrexate, 23% of patients experienced delayed excretion, in 4 cases with nephrotoxicity. Conclusions: In patients over 40 years of age with primary high-grade osteosarcoma, an aggressive approach with chemotherapy and surgery can offer the probability of survival similar to that achieved in younger patients. Chemotherapy-related toxicity is significant and generally higher than that reported in younger cohorts of osteosarcoma patients treated with more intensive regimens.
    Type of Medium: Online Resource
    ISSN: 0300-8916 , 2038-2529
    URL: Article
    DOI: 10.5301/tj.5000696
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2018
    detail.hit.zdb_id: 280962-X
    detail.hit.zdb_id: 2267832-3
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  • 3
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    High-Dose Treosulfan and Melphalan as Consolidation Therapy Versus Standard Therapy for High-Risk (Metastatic) Ewing Sarcoma
    American Society of Clinical Oncology (ASCO) ; 2022
    In:  Journal of Clinical Oncology Vol. 40, No. 21 ( 2022-07-20), p. 2307-2320
    Details
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 40, No. 21 ( 2022-07-20), p. 2307-2320
    Abstract: Ewing 2008R3 was conducted in 12 countries and evaluated the effect of treosulfan and melphalan high-dose chemotherapy (TreoMel-HDT) followed by reinfusion of autologous hematopoietic stem cells on event-free survival (EFS) and overall survival in high-risk Ewing sarcoma (EWS). METHODS Phase III, open-label, prospective, multicenter, randomized controlled clinical trial. Eligible patients had disseminated EWS with metastases to bone and/or other sites, excluding patients with only pulmonary metastases. Patients received six cycles of vincristine, ifosfamide, doxorubicin, and etoposide induction and eight cycles of vincristine, actinomycin D, and cyclophosphamide consolidation therapy. Patients were randomly assigned to receive additional TreoMel-HDT or no further treatment (control). The random assignment was stratified by number of bone metastases (1, 2-5, and 〉 5). The one-sided adaptive-inverse-normal-4-stage-design was changed after the first interim analysis via Müller-Schäfer method. RESULTS Between 2009 and 2018, 109 patients were randomly assigned, and 55 received TreoMel-HDT. With a median follow-up of 3.3 years, there was no significant difference in EFS between TreoMel-HDT and control in the adaptive design (hazard ratio [HR] 0.85; 95% CI, 0.55 to 1.32, intention-to-treat). Three-year EFS was 20.9% (95% CI, 11.5 to 37.9) in TreoMel-HDT and 19.2% (95% CI, 10.8 to 34.4) in control patients. The results were similar in the per-protocol collective. Males treated with TreoMel-HDT had better EFS compared with controls: median 1.0 years (95% CI, 0.8 to 2.2) versus 0.6 years (95% CI, 0.5 to 0.9); P = .035; HR 0.52 (0.28 to 0.97). Patients age 〈 14 years benefited from TreoMel-HDT with a 3-years EFS of 39.3% (95% CI, 20.4 to 75.8%) versus 9% (95% CI, 2.4 to 34); P = .016; HR 0.40 (0.19 to 0.87). These effects were similar in the per-protocol collective. This observation is supported by comparable results from the nonrandomized trial EE99R3. CONCLUSION In patients with very high-risk EWS, additional TreoMel-HDT was of no benefit for the entire cohort of patients. TreoMel-HDT may be of benefit for children age 〈 14 years.
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
    URL: Article
    DOI: 10.1200/JCO.21.01942
    RVK:
    XA 52760
    RVK:
    XA 10000
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2022
    detail.hit.zdb_id: 2005181-5
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  • 4
    Online Resource
    Online Resource
    Sarcoma of the Uterus. Guideline of the DGGG and OEGGG (S2k Level, AWMF Register Number 015/074, February 2019)
    Georg Thieme Verlag KG ; 2019
    In:  Geburtshilfe und Frauenheilkunde Vol. 79, No. 10 ( 2019-10), p. 1043-1060
    Details
    In: Geburtshilfe und Frauenheilkunde, Georg Thieme Verlag KG, Vol. 79, No. 10 ( 2019-10), p. 1043-1060
    Abstract: Ziel Offizielle Leitlinie, publiziert und koordiniert von der Deutschen Gesellschaft für Gynäkologie und Geburtshilfe (DGGG) und der Österreichischen Gesellschaft für Gynäkologie und Geburtshilfe (OEGGG). Aufgrund ihrer Seltenheit und heterogenen Histopathologie stellen uterine Sarkome eine Herausforderung bez. des klinischen Managements dar und bedürfen von daher eines multidisziplinären Ansatzes. Nach unserem Kenntnisstand existieren bis dato keine verbindlichen, evidenzbasierten Empfehlungen bez. des angemessenen Managements dieser heterogenen Tumoren. Methoden Die vorliegende S2k-Leitlinie wurde erstmals 2015 publiziert. Das nun hier publizierte Update ist erneut das Ergebnis eines Konsenses eines repräsentativen interdisziplinären Expertenkomitees, das im Rahmen des Leitlinienprogramms der DGGG, OEGGG und SGGG eine systematische Literaturrecherche zum Thema uterine Sarkome durchgeführt hat. Mitglieder der beteiligten Fachgesellschaften entwickelten in einem strukturierten Prozess einen moderierten formalen Konsensus. Empfehlungen Die konsentierten Empfehlungen und Statements beziehen sich auf die Epidemiologie, Klassifikation, Stadieneinteilung, Symptomatik, allgemeine Diagnostik, allgemeine Pathologie bzw. genetische Prädisposition von uterinen Sarkomen. Weiterhin werden Aussagen über das Management von Leiomyosarkomen, endometrialen Stromasarkomen (low- und high-grade) und undifferenzierten uterinen Sarkomen und Adenosarkomen getroffen. Abschließend werden die Nachsorge, das Morcellement und die Patientinnenaufklärung von bzw. bei uterinen Sarkomen erwähnt.
    Type of Medium: Online Resource
    ISSN: 0016-5751 , 1438-8804
    URL: Article
    DOI: 10.1055/a-0882-4116
    Language: English
    Publisher: Georg Thieme Verlag KG
    Publication Date: 2019
    detail.hit.zdb_id: 2026496-3
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