Publications by authors named "Lars Christian Horn"

Background: Most patients with unresectable locally advanced cutaneous squamous cell carcinoma (cSCC) benefit from cemiplimab, but some do not respond. Our study aims to identify clinical and histopathological features predicting response to cemiplimab.

Patients And Methods: We analyzed 15 patients treated with cemiplimab, assessing clinical, demographic, histopathological, and immunohistochemical characteristics and correlating them with treatment response.

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  • Low-grade serous ovarian carcinoma (LGSC) is a rare and dangerous type of ovarian cancer that is different from the more common high-grade version.
  • Researchers studied tissue samples from LGSC, high-grade serous ovarian carcinoma (HGSC), and serous borderline tumors (SBTs) to understand how they differ.
  • They found that the environment around the tumors was different in LGSC, including specific proteins and immune cells, which suggests that changing this environment could help develop new treatments.
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  • Cervical squamous cell carcinomas (CSCCs) linked to uterine prolapse show limited prior research, prompting a detailed study of their morphologic and molecular traits, including the identification of a new precursor lesion termed HPV-independent cervical intraepithelial neoplasia (CIN).
  • The study involved four patients, primarily older women with advanced disease and TP53 mutations, none showing the common HPV DNA typically associated with cervical cancer.
  • The precursor lesions displayed characteristics akin to differentiated vulvar intraepithelial lesions, suggesting a unique tumorigenetic pathway that differs from typical HPV-related processes.
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Background/aim: Texture analysis is a quantitative imaging technique that provides novel biomarkers beyond conventional image reading. This study aimed to investigate the correlation between texture parameters and histopathological features of lymph nodes in patients with vulvar cancer.

Patients And Methods: Overall, nine female patients (mean age 70.

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Mesonephric-like adenocarcinomas rarely occur in the uterus and the ovary. Benign mesonephric-like (ML) proliferations and hyperplasia have been described solely within the ovary. Pathogenetic data are very limited.

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Cells can adapt their active contractile properties to switch between dynamical migratory states and static homeostasis. Collective tissue surface tension, generated among others by the cortical contractility of single cells, can keep cell clusters compact, while a more bipolar, anisotropic contractility is predominantly used by mesenchymal cells to pull themselves into the extracellular matrix (ECM). Here, we investigate how these two contractility modes relate to cancer cell escape into the ECM.

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Objective: Vulvar squamous cell carcinoma (VSCC) can be stratified into three molecular subtypes based on the immunoexpression of p16 and p53: HPV-independent p53-abnormal (p53abn) (most common, biologically aggressive), HPV-associated, with p16-overexpression (second most common, prognostically more favourable) and more recently recognised HPV-independent p53-wildtype (p53wt) (rarest subtype, prognostically intermediate). Our aim was to determine whether molecular subtypes can be reliably identified in pre-operative biopsies and whether these correspond to the subsequent vulvectomy specimen.

Methods: Matched-paired pre-surgical biopsies and subsequent resection specimen of 57 patients with VSCC were analysed for the immunohistochemical expression of p16 and p53 by performing a three-tiered molecular subtyping to test the accuracy rate.

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In cancer of the uterine cervix, the role of desmoplasia, i.e., peritumoral stromal remodeling characterized by fibroblast activation and increased extracellular matrix deposition, is not established.

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Background: Histopathological examination is still the backbone for the diagnosis and treatment decision making in endometrial carcinoma (EC). The binary classification of EC into type 1 (mostly endometrioid) and type 2 (mostly serous), although still helpful, showed overlapping clinical, morphological and molecular features and was not very prognostic discriminatory for all subtypes of EC.

Methods: Analysing the most recent studies dealing with the molecular classification of EC and the recommendations of the German S3-guidelines for EC.

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  • Mesonephric-like adenocarcinomas (MLAs) are rare cancers of the female genital tract that usually have a KRAS mutation and tend to be aggressive.
  • Researchers studied eight MLAs and found that about 85% have a KRAS mutation, particularly affecting specific parts of the gene, but some have no mutation at all.
  • Only a small percentage of MLAs with a certain type of KRAS mutation can be treated with a specific drug, and the different locations of these mutations don't seem to affect how well patients do.
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The S3-guideline on endometrial cancer, first published in April 2018, was reviewed in its entirety between April 2020 and January 2022 and updated. The review was carried out at the request of German Cancer Aid as part of the Oncology Guidelines Program and the lead coordinators were the German Society for Gynecology and Obstetrics (DGGG), the Gynecology Oncology Working Group (AGO) of the German Cancer Society (DKG) and the German Cancer Aid (DKH). The guideline update was based on a systematic search and assessment of the literature published between 2016 and 2020.

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  • - The S3-guideline for endometrial cancer, initially released in April 2018, underwent a comprehensive review and update from April 2020 to January 2022, as requested by German Cancer Aid and coordinated by prominent gynecological and oncology organizations in Germany.
  • - The update focused on integrating new evidence and refining recommendations to enhance treatment approaches, emphasizing personalized therapies to minimize unnecessary radical surgeries and non-beneficial adjuvant treatments for low-risk patients.
  • - The revised guideline aims to optimize care for high-risk patients by clarifying the roles of radical surgery and additional treatments, ultimately improving survival rates and quality of life, while serving as a foundation for certified gynecological cancer centers.
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  • Cancer progression results from genetic changes that alter cell properties and the mechanical state of tumors, with increased stiffness recognized but having limited prognostic utility.
  • Recent research suggests that tissue fluidization occurs alongside cancer progression, leading to changes in tissue behavior influenced by factors like cellular activity and microenvironment.
  • Advanced techniques, such as multifrequency magnetic resonance elastography, can differentiate tumors from surrounding tissues, and a meta-analysis identifies key mechanical characteristics that could help predict tumor aggressiveness and metastatic potential.
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The aim was to develop and update a guideline which would improve the quality of care offered to women with gestational and non-gestational trophoblastic disease, a group of diseases characterized by their rarity and biological heterogeneity. In accordance with the method used to compile S2k-guidelines, the guideline authors carried out a search of the literature (MEDLINE) for the period 1/2020 to 12/2021 and evaluated the recent literature. No key questions were formulated.

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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.

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Objectives: Vulvar squamous cell carcinoma is subclassified into three prognostically relevant groups: (i) human papillomavirus (HPV) associated, (ii) HPV independent p53 abnormal (mutant pattern), and (iii) HPV independent p53 wild type. Immunohistochemistry for p16 and p53 serve as surrogates for HPV viral integration and mutational status. We assessed the reproducibility of the subclassification based on p16 and p53 immunohistochemistry and evaluated the prognostic significance of vulvar squamous cell carcinoma molecular subgroups in a patient cohort treated by vulvar field resection surgery.

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Background: Pregnant women are also susceptible to SARS-CoV-2. Although an infection of the placenta may be rare, pregnancy may occasionally be affected by intrauterine failure. The knowledge of placental morphology on sudden intrauterine demise is still limited.

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In breast cancer therapeutic decisions are based on the expression of estrogen (ER), progesterone (PR), the human epidermal growth factor 2 (HER2) receptors and the proliferation marker Ki67. However, only little is known concerning heterogeneity between the primary tumor and axillary lymph node metastases (LNM) in the primary site. We retrospectively analyzed receptor profiles of 215 early breast cancer patients with axillary synchronous LNM.

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The 2020 WHO Classification defines the spindle cell, epithelioid, and myxoid variants as subtypes of uterine leiomyosarcomas (LMS). Presence of cellular atypia (size variation of polymorphic nuclei > 2-3:1), tumor cell necroses, and mitotic count (usually ≥ 10 MF/10 HPF) are still the key features for diagnostic separation from uterine leiomyomas. Preanalytic variables, staining quality, as well as intralesional geographic distribution may affect the mitotic count.

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Purpose: Ovarian carcinomas (OCX) have traditionally been thought to arise from the ovarian surface epithelium. However, recent (immuno-) histopathological and molecular analyses suggest that OCX consist of morphological subtypes with different epidemiologic features and a varying prognosis.

Methods: The data of 482 OCX from the Clinical Cancer Registry of Leipzig who were surgically treated between 2000 and 2019 and were evaluated regarding incidence, clinico-pathologic characteristics and prognostic factors.

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Uterine sarcomas are a heterogeneous group of rare malignancies. Mostly (40-50%), they are leiomyosarcomas, followed by endometrial stromal sarcomas (ESS), low-grade (LG) and high-grade (HG), as well as undifferentiated sarcoma of the uterus (UUS) and adenosarcomas (AS). Other, non-organ-specific tumours such as NTRK-rearranged spindle cell neoplasia, perivascular epithelioid cell tumour (PEComa) and inflammatory myofibroblastic tumour (IMT) are extremely difficult to differentiate.

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This is an update of the interdisciplinary S3-guideline on the Diagnosis, Therapy and Follow-up of Cervical Cancer (AWMF Registry No. 032/033OL), published in March 2021. The work on the updated guideline was funded by German Cancer Aid as part of the German Guideline Program in Oncology.

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  • In 2021, new guidelines were made for diagnosing and treating a type of cancer called uterine cervical carcinoma, updating rules from 2015.
  • Pathologists now need to use a system that tells apart cancers caused by HPV from those that aren't, and look closely at how the cancer is growing.
  • When studying the tumors, they need to make sure to check all parts carefully, especially if the tumor is bigger than 2 cm, and follow specific rules for surgeries and testing the lymph nodes.
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This update of the interdisciplinary S3 guideline on the Diagnosis, Therapy and Follow-up of Cervical Cancer (AWMF Registry No. 032/033OL) was published in March 2021. This updated guideline was funded by German Cancer Aid as part of the German Guideline Program in Oncology.

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