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  1. Article ; Online: Surgery for recurrent ovarian cancer: Options and limits.

    Sehouli, J / Grabowski, J P

    Best practice & research. Clinical obstetrics & gynaecology

    2017  Volume 41, Page(s) 88–95

    Abstract: Cytoreductive surgery is the backbone of the multimodal therapy in primary ovarian cancer patients. Despite the effect of various tumor biological factors such as grading and histological subtype, the surgical outcome is the most important prognostic ... ...

    Abstract Cytoreductive surgery is the backbone of the multimodal therapy in primary ovarian cancer patients. Despite the effect of various tumor biological factors such as grading and histological subtype, the surgical outcome is the most important prognostic factor for both progression free- and overall survival. In contrast, the management of recurrent situation has long remained a subject of an emotional international discussion. To date, only few prospective studies have focused on the effect of surgery in relapsed ovarian cancer. The available retrospective data associate complete cytoreduction with prognosis improvement. However, the selection of patients eligible for surgery in recurrent situation is the essential issue. The establishment of predictive factors for complete tumor resection and defining the patient group with recurrent disease who might profit from this approach are crucial. The available predictors of complete resection depend on the results of primary surgery and the current patient's situation. Women who underwent primary complete cytoreduction are in good performance status, and those who have only minimal ascites volume (less than 500 ml) in the recurrent situation have 76% likelihood of undergoing complete resection and survival prolongation. Moreover, the complete cytoreduction in the tertiary cytoreductive approach has been evaluated and showed a potential positive influence on patients' survival. This review concentrates on the recent data and highlights the need of further randomized trials to develop and incorporate operative standards in recurrent ovarian cancer.
    Language English
    Publishing date 2017-05
    Publishing country Netherlands
    Document type Journal Article ; Review
    ZDB-ID 2050090-7
    ISSN 1532-1932 ; 1521-6934
    ISSN (online) 1532-1932
    ISSN 1521-6934
    DOI 10.1016/j.bpobgyn.2016.10.009
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Current management of ovarian cancer.

    Grabowski, J P / Sehouli, J

    Minerva medica

    2015  Volume 106, Issue 3, Page(s) 151–156

    Abstract: Cytoreductive surgery remains an accepted standard treatment of primary ovarian cancer. In advanced stages adjuvant platin/taxane chemotherapy with addition of anti-angiogenic agent, i.e., bevacizumab is recommended. The management of recurrent ovarian ... ...

    Abstract Cytoreductive surgery remains an accepted standard treatment of primary ovarian cancer. In advanced stages adjuvant platin/taxane chemotherapy with addition of anti-angiogenic agent, i.e., bevacizumab is recommended. The management of recurrent ovarian cancer remains a field of controversies. Surgery and/or systemic treatment are currently investigated in prospective trials. Retrospective data show prognosis improvement in patients who underwent complete cytoreduction. Thus, the selection of patients eligible for surgery in recurrent situation is the essential issue. The available predictors of complete resection depend on results of primary surgery and current patients situation. Women who fulfill these criteria have 76% likelihood of undergoing complete resection and survival prolongation. On the other hand there is a large group of patients in whom surgery might be too dangerous and demand an effective systemic treatment. Currently in a second-line several options are available, again including anti-angiogenic agents. The management of further recurrences is a subject of several clinical trials, nevertheless standards are still missing. Due to histological subtype and/or BRCA mutation status, the therapy in ovarian cancer might undergo revision in a near future.
    MeSH term(s) Female ; Forecasting ; Humans ; Neoplasm Staging ; Ovarian Neoplasms/pathology ; Ovarian Neoplasms/therapy
    Language English
    Publishing date 2015-06
    Publishing country Italy
    Document type Journal Article ; Review
    ZDB-ID 123586-2
    ISSN 1827-1669 ; 0026-4806
    ISSN (online) 1827-1669
    ISSN 0026-4806
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article: Aktuelle Aspekte in der BRCA-Diagnostik: Konsequenzen für Prävention und Therapie. Current aspects of BRCA analysis: consequences for prevention and therapy

    Speiser, D. / Grabowski, J. P. / Schmitt, W. D.

    Der Onkologe

    2019  Volume 25, Issue 2, Page(s) 107

    Language German
    Document type Article
    ZDB-ID 1229978-9
    ISSN 0947-8965
    Database Current Contents Medicine

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  4. Article ; Online: Survival and prognostic factors in patients with recurrent low-grade epithelial ovarian cancer: An analysis of five prospective phase II/III trials of NOGGO metadata base.

    Canaz, E / Grabowski, J P / Richter, R / Braicu, E I / Chekerov, R / Sehouli, J

    Gynecologic oncology

    2019  Volume 154, Issue 3, Page(s) 539–546

    Abstract: Objective: Low-grade epithelial ovarian cancers (EOC), constitute the minority among all epithelial cancers. Our study objective was to focus on low-grade recurrent EOC and compare the survival with high-grade disease, as well as in regard to "platinum- ... ...

    Abstract Objective: Low-grade epithelial ovarian cancers (EOC), constitute the minority among all epithelial cancers. Our study objective was to focus on low-grade recurrent EOC and compare the survival with high-grade disease, as well as in regard to "platinum-sensitive" and "-resistant" recurrences according to platinum-free interval.
    Methods: This is an exploratory analysis within the North-Eastern German Society of Gynecological Oncology (NOGGO) database including five randomized phase II/III trials comparing different chemotherapy regimens in recurrent EOC. We conducted survival analyses and cox-proportional regression models.
    Results: Out of 1050 patients having the first recurrence, 42 (4%) patients had low-grade and 1008 (96%) patients had high-grade disease. In the subgroup of platinum-sensitive recurrences, progression-free survival (PFS) (8.7 m vs 9.7 m, p = 0.7) and overall survival (OS) (23.9 m vs 24.8 m, p = 0.9) did not differ between low-grade and high-grade diseases. In platinum-resistant recurrences, patients with low-grade ovarian cancer had significantly better PFS (7.6 m vs 3.6 m, p = 0.03) and OS (41.9 m vs 9.5 m p = 0.002) in comparison to those with high-grade cancer. At low-grade EOC, there were no significant PFS (p = 0.91) and OS (p = 0.25) differences between platinum-sensitive and -resistant recurrences. Patients with low-grade non-serous histology had lower PFS with compared to those with low-grade serous histology (p = 0.004). At cox regression analysis presence of ascites and residual disease after secondary cytoreductive surgery were independently associated with poor PFS within low-grade recurrent EOC.
    Conclusion: Our study indicates, platinum-free interval does not have any prognostic significance at recurrent low-grade EOC and non-serous histology is associated with poorer outcome in recurrence. Secondary surgical cytoreduction to no-gross residual disease and ascites are independently associated with disease progression.
    MeSH term(s) Adult ; Aged ; Aged, 80 and over ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use ; Carcinoma, Ovarian Epithelial/drug therapy ; Carcinoma, Ovarian Epithelial/mortality ; Carcinoma, Ovarian Epithelial/pathology ; Clinical Trials, Phase II as Topic ; Clinical Trials, Phase III as Topic ; Drug Resistance, Neoplasm ; Female ; Humans ; Middle Aged ; Neoplasm Grading ; Neoplasm Recurrence, Local/drug therapy ; Neoplasm Recurrence, Local/mortality ; Neoplasm Recurrence, Local/pathology ; Organoplatinum Compounds/administration & dosage ; Ovarian Neoplasms/drug therapy ; Ovarian Neoplasms/mortality ; Ovarian Neoplasms/pathology ; Prognosis ; Proportional Hazards Models ; Randomized Controlled Trials as Topic ; Survival Analysis ; Topotecan/administration & dosage ; Young Adult
    Chemical Substances Organoplatinum Compounds ; Topotecan (7M7YKX2N15)
    Language English
    Publishing date 2019-06-21
    Publishing country United States
    Document type Journal Article
    ZDB-ID 801461-9
    ISSN 1095-6859 ; 0090-8258
    ISSN (online) 1095-6859
    ISSN 0090-8258
    DOI 10.1016/j.ygyno.2019.06.014
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Carcinoma of the recto-vaginal septum. Comprehensive literature review.

    Lopez, N / Grabowski, J P / De Santiago, J / Zapardiel, I

    Journal of obstetrics and gynaecology : the journal of the Institute of Obstetrics and Gynaecology

    2016  Volume 36, Issue 4, Page(s) 450–454

    Abstract: Carcinoma of the recto-vaginal septum is an extremely rare entity. We performed a MEDLINE-based search on recto-vaginal septum carcinoma, focussing on its management, in order to clarify which are the best treatment options for this disease. In addition ... ...

    Abstract Carcinoma of the recto-vaginal septum is an extremely rare entity. We performed a MEDLINE-based search on recto-vaginal septum carcinoma, focussing on its management, in order to clarify which are the best treatment options for this disease. In addition an unpublished case report has been added to the review. 34 case reports were included in our review. Surgery and adjuvant chemoradiation therapy seem to be the most common treatment option. However, since primary surgical treatment leads to mutilation by removing a large portion of the vagina and the anal sphincter with a permanent terminal colostomy, primary platinum-based chemoradiation therapy could be considered. In case of extragastrointestinal stromal tumours primary surgical treatment seems to be the best option. Due to the rarity of this entity only limited data is available. Therefore further investigation is necessary.
    MeSH term(s) Adult ; Anal Canal/surgery ; Carcinoma/pathology ; Carcinoma/therapy ; Chemoradiotherapy, Adjuvant/methods ; Combined Modality Therapy ; Female ; Humans ; Rectal Neoplasms/pathology ; Rectal Neoplasms/therapy ; Vagina/surgery ; Vaginal Neoplasms/pathology ; Vaginal Neoplasms/therapy
    Language English
    Publishing date 2016-05
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 604639-3
    ISSN 1364-6893 ; 0144-3615
    ISSN (online) 1364-6893
    ISSN 0144-3615
    DOI 10.3109/01443615.2015.1065234
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  6. Article ; Online: Prognostic role of chemotherapy-induced nausea and vomiting in recurrent ovarian cancer patients: results of an individual participant data meta-analysis in 1213.

    Woopen, Hannah / Richter, R / Chekerov, R / Inci, G / Alavi, S / Grabowski, J P / Sehouli, J

    Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer

    2019  Volume 28, Issue 1, Page(s) 73–78

    Abstract: Background: The aim of this study was to analyze the potential impact of chemotherapy-induced nausea and vomiting (CINV) on dose reductions, discontinuation of chemotherapy, and survival.: Patients and methods: This study was designed as individual ... ...

    Abstract Background: The aim of this study was to analyze the potential impact of chemotherapy-induced nausea and vomiting (CINV) on dose reductions, discontinuation of chemotherapy, and survival.
    Patients and methods: This study was designed as individual participant data meta-analysis with the original study data of three phase II/III trials that were conducted by the North-Eastern German Society of Gynecological Oncology (NOGGO) including 1213 patients with recurrent ovarian cancer. Logistic and Cox regression analyses were used to estimate odds and hazard ratios after adjusting for age, ECOG, amount of delivered cycles, amount of recurrences, and amount of comedications and study.
    Results: The majority of patients developed nausea (58.1%) and almost one third experienced vomiting (31.0%). CINV was not associated with FIGO stage, grading, histology, and number of recurrences. The necessity of dose reduction and discontinuation of chemotherapy did not correlate to nausea and vomiting (p = 0.88, p = 0.39 and p = 0.25, p = 0.54 respectively). Progression-free survival was shorter in patients with grade III/IV nausea and vomiting (p = 0.02; hazard ratio (HR) for grade III/IV nausea 1.58, 95% CI 1.14-2.20, and p = 0.02; HR for grade III/IV vomiting 1.67, 95% CI 1.15-2.42 respectively). CINV grade III/IV was also associated with poorer overall survival (p < 0.001; HR for grade III/IV nausea 2.35, 95% CI 1.64-3.37, and p < 0.001; HR for grade III/IV vomiting 1.67, 95% CI 1.15-2.42 respectively).
    Conclusion: CINV is significantly associated with poorer prognosis in recurrent ovarian cancer patients while there was no correlation found with the necessity of dose reduction and prior discontinuation of treatment. This study underlines the importance of prevention and treatment of CINV as part of early best supportive care.
    MeSH term(s) Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols/adverse effects ; Carcinoma, Ovarian Epithelial/diagnosis ; Carcinoma, Ovarian Epithelial/drug therapy ; Carcinoma, Ovarian Epithelial/pathology ; Clinical Trials, Phase II as Topic/statistics & numerical data ; Clinical Trials, Phase III as Topic/statistics & numerical data ; Female ; Humans ; Induction Chemotherapy/adverse effects ; Middle Aged ; Nausea/chemically induced ; Nausea/diagnosis ; Neoplasm Recurrence, Local/diagnosis ; Neoplasm Recurrence, Local/drug therapy ; Neoplasm Recurrence, Local/pathology ; Ovarian Neoplasms/diagnosis ; Ovarian Neoplasms/drug therapy ; Ovarian Neoplasms/pathology ; Predictive Value of Tests ; Prognosis ; Progression-Free Survival ; Treatment Outcome ; Vomiting/chemically induced ; Vomiting/diagnosis
    Language English
    Publishing date 2019-04-13
    Publishing country Germany
    Document type Journal Article ; Meta-Analysis
    ZDB-ID 1134446-5
    ISSN 1433-7339 ; 0941-4355
    ISSN (online) 1433-7339
    ISSN 0941-4355
    DOI 10.1007/s00520-019-04778-1
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  7. Article: Olaparib bei Ovarialkarzinom (Lynparza™)

    Glajzer, J. / Grabowski, J. P. / Muallem, M. Z. / Sehouli, J.

    Tägliche Praxis

    2017  Volume 59, Issue 2, Page(s) 344

    Language German
    Document type Article
    ZDB-ID 506157-x
    ISSN 0494-464X
    Database Current Contents Medicine

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  8. Article: Olaparib bei Ovarialkarzinom (Lynparza)

    Glajzer, J. / Grabowski, J. P. / Muallem, M. Z. / Sehouli, J.

    Internistische Praxis

    2017  Volume 58, Issue 2, Page(s) 348

    Language German
    Document type Article
    ZDB-ID 209039-9
    ISSN 0020-9570
    Database Current Contents Medicine

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  9. Article: Olaparib bei Ovarialkarzinom (Lynparza)

    Glajzer, J. / Grabowski, J. P. / Muallem, M. Z. / Sehouli, J.

    Chirurgische Praxis

    2017  Volume 83, Issue 1, Page(s) 162

    Language German
    Document type Article
    ZDB-ID 500633-8
    ISSN 0009-4846
    Database Current Contents Medicine

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  10. Article: Olaparib bei Ovarialkarzinom (Lynparza)

    Glajzer, J. / Grabowski, J. P. / Muallem, M. Z. / Sehouli, J.

    Gynäkologische Praxis

    2017  Volume 42, Issue 3, Page(s) 530

    Language German
    Document type Article
    ZDB-ID 80452-6
    ISSN 0341-8677
    Database Current Contents Medicine

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