Publications by authors named "Carolin Siech"
Background: Video content has become an increasingly valuable tool in medical education, particularly for teaching hands-on skills like sonography and clinical examination. This study evaluates the satisfaction and content of sonography and clinical examination videos on the AMBOSS platform, a prominent medical education resource in Germany.
Objective: The goal of this study was to compare how effective and well-received sonography and clinical examination videos are on the AMBOSS platform.
Hormonal agents administered for metastatic castration-resistant prostate cancer (mCRPC) may lead to osteoporosis, skeletal events, reduced quality of life, and even reduced overall survival (OS). Bone-modifying agents may prevent those events but their effect on cancer-control outcomes remains uncertain. Relying on our institutional tertiary-care database, we explored the effect of bone-modifying agents (bisphosphonates such as zoledronic acid and denosumab) on OS and progression-free survival in patients with mCRPC with at least 1 bone metastasis using Kaplan-Meyer estimates and Cox regression models.
View Article and Find Full Text PDFPurpose: Temporal trends in and predictors of inpatient palliative care use in patients with metastatic renal cell carcinoma (mRCC) undergoing critical care therapy are unknown.
Methods: Relying on the National Inpatient Sample (2008-2019), we identified mRCC patients undergoing critical care therapy, namely invasive mechanical ventilation, percutaneous endoscopic gastrostomy tube insertion, dialysis for acute kidney failure, total parenteral nutrition, or tracheostomy. Estimated annual percentage changes (EAPC) analyses and multivariable logistic regression models addressed inpatient palliative care use.
Background And Objective: Patients struggle to classify symptoms, which hinders timely medical presentation. With 35-75% of patients seeking information online before consulting a health care professional, generative language-based artificial intelligence (AI), exemplified by ChatGPT-3.5 (GPT-3.
View Article and Find Full Text PDFLu-vipivotide tetraxetan prostate-specific membrane antigen (Lu-PSMA) therapy is under current scientific investigation and aims to become established in the treatment of metastatic castration-resistant prostate cancer (mCRPC). However, real-world evidence in treatment comparison is scant. We relied on the FRAMCAP database and compared cabazitaxel versus Lu-PSMA therapy in mCRPC patients regarding progression-free survival (PFS) and overall survival (OS).
View Article and Find Full Text PDFBackground: The role of primary tumor ablation (pTA) in metastatic renal cell carcinoma (mRCC) is unknown. We compared pTA-treated mRCC patients to patients who underwent no local treatment (NLT), as well as patients who underwent cytoreductive nephrectomy (CN).
Methods: Within the Surveillance, Epidemiology, and End Results database (SEER, 2004-2020), we identified mRCC patients who underwent either pTA, NLT or CN.
Article Synopsis
- The study investigated the relationship between lymphovascular invasion (LVI) and perineural invasion (PNI) in prostate cancer patients who underwent radical prostatectomy and their rates of biochemical recurrence (BCR).
- Results from 822 patients showed that those with LVI had a five-year BCR-free survival rate of 62%, while those with PNI had a rate of 64%, both lower than their counterparts without these invasions.
- After adjusting for factors like age, PSA levels, and tumor stage, the association between LVI and PNI with BCR became insignificant, indicating that tumor stage and Gleason Grade were more critical predictors of recurrence.
Article Synopsis
- The study focuses on understanding how different metastatic sites (lymph nodes, bones, and visceral organs) affect outcomes in patients with metastatic castration-resistant prostate cancer (mCRPC), specifically regarding progression-free survival (PFS) and overall survival (OS).
- Using data from the Frankfurt Metastatic Cancer Database, researchers classified 363 patients based on their metastatic sites and analyzed PFS and OS using Cox regression models.
- Results showed that M1c mCRPC patients have significantly worse outcomes, with higher risks for both progression and death compared to M1a patients, while M1a patients experienced the best outcomes overall.
: Progression to metastatic castration-resistant prostate cancer (mCRPC) is defined either biochemically, radiographically or both. Moreover, staging for mCRPC can be performed either conventionally or with molecular imaging such as prostate-specific membrane antigen computer tomography (PSMA-PET/CT). : We relied on the Frankfurt Metastatic Cancer Database of the Prostate (FRAMCAP) database to compare progression-free (PFS) and overall survival (OS) outcomes regarding the cause of castration resistance and the staging modality used.
View Article and Find Full Text PDFIntroduction: Neoadjuvant chemotherapy (NAC) before radical cystectomy (RC) is guideline-recommended in patients with cT2-T4N0M0 urothelial carcinoma of urinary bladder (UCUB). However, no population-based study validated the survival benefit of NAC recorded in clinical trials in a stage-specific fashion. We addressed this knowledge gap.
View Article and Find Full Text PDFArticle Synopsis
- The study investigates the use of critical care therapies (CCT) like invasive mechanical ventilation and total parenteral nutrition in patients following radical nephroureterectomy for upper urinary tract carcinoma, revealing an unclear relationship with in-hospital mortality.
- An analysis of 8,995 non-metastatic UUTC patients from 2008-2019 found that 4.2% received CCT, with a notable correlation between the rates of CCT and in-hospital mortality over time.
- Findings suggest that CCT is more common among older and sicker patients, while a decline in CCT and mortality rates indicates improvements in care quality, with an ideal scenario showing that in-hospital deaths should follow CCT exposure.
Article Synopsis
- This study looked at how paraplegia affects risks during and after surgery for bladder cancer.
- Out of over 25,000 patients, very few (185) were paraplegic, and they had more complications and higher death rates after surgery compared to people without paraplegia.
- The findings suggest that doctors should inform paraplegic patients about the increased risks before they undergo surgery for bladder cancer.
Article Synopsis
- This study looked at two types of cancer treatment: Trimodal Therapy (TMT) and External Beam Radiation Therapy (EBRT) for bladder cancer patients.
- It found that TMT helped more patients live longer compared to EBRT, especially in those with earlier stages of cancer.
- However, TMT didn't show a survival advantage in patients with more advanced cancer stages.
Background: The use of inpatient palliative care (IPC) in advanced cancer patients represents a well-established guideline recommendation. This study examines the utilization rates and patterns of IPC among patients with metastatic adrenocortical carcinoma (mACC).
Methods: Relying on the Nationwide Inpatient Sample database (2007-2019), we tabulated IPC rates in mACC patients.
Article Synopsis
- This study analyzed the clinicopathologic characteristics and treatment patterns of adult prostate sarcoma patients using data from the Surveillance, Epidemiology, and End Results database between 2004 and 2020.
- Among 125 patients, the most common subtype was leiomyosarcoma (36%), with rhabdomyosarcoma (14%) being more likely to present at a metastatic stage compared to other types.
- The overall median survival was 27 months, with treatment approaches differing significantly based on the subtype; metastatic disease was linked to higher mortality rates, while stromal sarcoma had a lower overall mortality risk.
Background: The shortage of skilled labor in medicine is one of the most pressing challenges in healthcare. The increasing number of women in medicine, particularly in the field of urology, raises questions about the compatibility of family and career, especially concerning the work environment and working time models.
Objective: The aim of this study is to capture the impact of motherhood on the professional lives of female physicians and scientists in the field of urology in Germany.
Article Synopsis
- Simulation-based training in urology is becoming increasingly important, and a study assessed its impact on the surgical confidence of residents after a workshop focused on ureteroscopy (URS) and transurethral resection of the bladder (TURB).
- The workshop involved 40 participants, and results showed that while men generally reported higher surgical confidence before and after the session, both genders experienced an increase in confidence after the training.
- Despite achieving similar surgical performance outcomes, women were less confident in performing URS tasks compared to men, indicating a gap that could be addressed through targeted support and training.
Article Synopsis
- Complete surgical resection (adrenalectomy) is the only potential cure for metastatic adrenocortical carcinoma (mACC), but its impact on survival rates has been unclear.
- A study using the SEER database from 2004 to 2020 analyzed the effects of adrenalectomy on the survival of mACC patients and found that those who underwent the surgery had significantly lower mortality rates.
- The results indicated that while adrenalectomy benefits many, its effectiveness may vary based on factors like the type of systemic therapy received and the number of metastatic sites.
Race/Ethnicity Affects Access and Survival Differences After Neoadjuvant or Adjuvant Chemotherapy at Radical Cystectomy in Urothelial Carcinoma Patients.
J Racial Ethn Health Disparities
August 2024
Introduction: It is unknown whether race/ethnicity affects access and/or survival after neoadjuvant (NAC) or adjuvant chemotherapy (ADJ) at radical cystectomy (RC). We addressed these knowledge gaps.
Material And Methods: Within the Surveillance, Epidemiology, and End Results database (2007-2020), we identified NAC candidates (T2-T4N0M0) and ADJ candidates (T3-T4 and/or N1-3).