Publications by authors named "Maximilian Klar"
Introduction: The aim of the study was to evaluate the effectiveness of cerclage in women with previous late miscarriages or premature births. The primary aim was to prolong pregnancy and achieve a term delivery. Secondarily, it was investigated whether an intervention after an early pathological 75-g-oGTT result influences these endpoints.
View Article and Find Full Text PDFArticle Synopsis
- - This study looked at whether patients with stage IC grade 1 endometrioid ovarian carcinoma benefit from post-operative chemotherapy, using data from the National Cancer Institute's SEER program, involving 1207 patients treated between 2007 and 2020.
- - The findings showed that for patients with grade 1 tumors, there was no significant difference in 5-year survival rates (over 90%) whether or not they received chemotherapy, but those who didn't have nodal evaluation had significantly lower survival rates compared to those who did.
- - The implications suggest that while chemotherapy may not be necessary for grade 1 tumors with nodal evaluation, it becomes crucial for patients without such evaluations, indicating a need for tailored treatment approaches based on
Objective: To describe population-level utilization of fertility-sparing surgery and outcome of reproductive-aged patients with early epithelial ovarian cancer who underwent fertility-sparing surgery in the United States.
Methods: This retrospective study queried the National Cancer Institute's Surveillance, Epidemiology, and End Result Program. The study included 3,027 patients younger than age 50 years with stage I epithelial ovarian cancer receiving primary surgical therapy from 2007 to 2020.
Objective: To assess the prognostic performance of the 2023 International Federation of Gynecology and Obstetrics (FIGO) endometrial cancer staging schema.
Methods: This retrospective cohort study queried the Commission-on-Cancer's National Cancer Database. Study population was 129,146 patients with stage I-IV endometrial cancer per the 2009 FIGO staging schema.
Background: Although hysteropexy has been used to preserve the uterus during uterine prolapse surgery for a long time, there is a scarcity of data that describe the nationwide patterns of use of this surgical procedure.
Objective: This study aimed to examine the national-level use and characteristics of hysteropexy at the time of laparoscopic apical suspension surgery for uterine prolapse in the United States.
Study Design: This cross-sectional study used data from the Healthcare Cost and Utilization Project's Nationwide Ambulatory Surgery Sample.
Purpose: To examine the utilization and characteristics related to the use of hysteroscopy at the time of endometrial evaluation for endometrial hyperplasia in the outpatient surgery setting.
Methods: This cross-sectional study queried the Healthcare Cost and Utilization Project's Nationwide Ambulatory Surgery Sample. The study population was 3218 patients with endometrial hyperplasia who underwent endometrial evaluation from January 2016 to December 2019.
Objective: To assess population-level trends, characteristics, and outcomes of high-grade serous tubo-ovarian carcinoma in the United States.
Methods: This retrospective cohort study queried the National Cancer Institute's Surveillance, Epidemiology, and End Results Program. The study population was 27,811 patients diagnosed with high-grade serous tubo-ovarian carcinoma from 2004 to 2020.
Importance: Isolated tumor cells (ITCs) are the histopathological finding of small clusters of cancer cells no greater than 0.2 mm in diameter in the regional lymph nodes. For endometrial cancer, the prognostic significance of ITCs is uncertain.
View Article and Find Full Text PDFArticle Synopsis
- The study investigates early death rates among patients with gynecologic cancers in the U.S., focusing on racial and ethnic differences, using data from 461,300 patients between 2000 and 2020.
- Findings reveal that 4.7% of the cohort experienced early death, with notably higher rates in non-Hispanic Black patients for tubo-ovarian cancer (14.5%).
- Overall, while early death rates decreased for both non-Hispanic Black and White patients over time, significant racial disparities persisted, particularly in tubo-ovarian and uterine cancers.
Objective: To assess survival outcomes of stage IA3 endometrial cancer and the association of adjuvant therapy and survival.
Methods: The National Cancer Database was retrospectively queried to examine 594 and 1455 patients with stage IA3 and IIIA1 endometrial cancer, respectively, from 2010-2015. Overall survival (OS) was examined based on adjuvant therapy: multimodal combination chemotherapy and external beam radiotherapy, chemotherapy alone, external beam radiotherapy alone, and none.
Introduction: Risk factors for postpartum depression include a lack of social support and perceived social isolation. We would like to determine whether the isolation of inpatients on the maternity wards during Covid-19 leads to increased psychological stress.
Methods: This is a multicentre, controlled study of obstetric patients who gave birth during an inpatient stay.
In this cross-sectional study including 1,722,479 women who underwent laparoscopic cholecystectomy between January 2016 and December 2019 identified in the Healthcare Cost and Utilization Project's Nationwide Ambulatory Surgery Sample, the prevalence rate of gynecologic diagnoses was 11.3 per 1,000. Among presumed elective laparoscopic cholecystectomy, the highest performance rate of concurrent gynecologic procedure per gynecologic diagnosis was laparoscopic adnexectomy among patients with benign ovarian tumor (652/1,000 diagnoses), followed by laparoscopic adnexectomy for endometrioma (386/1,000 diagnoses) and cervical conization for cervical carcinoma in situ (304/1,000 diagnoses).
View Article and Find Full Text PDFObjective: Failure-to-rescue, defined as mortality following a perioperative complication, is a perioperative quality indicator studied in various surgeries, but not in vulvar cancer surgery. The objective of this study was to assess failure-to-rescue in patients undergoing surgical therapy for vulvar cancer.
Methods: This cross-section study queried the National Inpatient Sample.
Introduction: Since malignancy during pregnancy is uncommon, information regarding contraception selection or sterilization at delivery is limited. The objective of this study was to examine the type of long-acting reversible contraception or surgical sterilization procedure chosen by pregnant patients with malignancy at delivery.
Material And Methods: This cross-sectional study queried the Healthcare Cost and Utilization Project's National Inpatient Sample in the USA.
Purpose: Endometrial cancer (EC) is the most common gynecological malignancy in women, with increasing incidence in the last decades. Surgical therapy is the mainstay of the initial management. The present study analyzed the evolving trends of surgical therapy in Germany in patients diagnosed with EC recorded in a nationwide registry.
View Article and Find Full Text PDFArticle Synopsis
- A study was conducted to evaluate the effectiveness of neoadjuvant chemotherapy (NACT) in less common types of epithelial ovarian cancer, as previous trials primarily focused on high-grade serous carcinomas.
- The research involved a retrospective analysis using data from the National Cancer Database, reviewing cases from 2006 to 2017, and included patients with advanced stages of clear cell, mucinous, and low-grade serous ovarian cancers.
- Findings showed that the use of NACT increased significantly among patients with clear cell and low-grade serous carcinomas, indicating a positive trend in treatment uptake, but overall survival comparisons were also needed for a better understanding of outcomes.
Objective: To examine uptake, characteristics, and survival outcome of less-radical fertility-sparing surgery with cervical conization and lymph node evaluation (Cone-LN) in reproductive age patients with early cervical cancer.
Methods: This retrospective cohort study examined the National Cancer Institute's Surveillance, Epidemiology, and End Results Program. The study population included 407 patients aged <50 years with stage IA-IB2 (≤4 cm) cervical cancer who received fertility-sparing surgery from 2004 to 2019.
Importance: While the characteristics of COVID-19 infection and mortality among patients with a malignant neoplasm have previously been examined, little data are available for gender-specific COVID-19 mortality.
Objective: To examine the gender-specific COVID-19 case fatality risks among patients with a malignant neoplasm.
Design, Setting, And Participants: In this cohort study using the Healthcare Cost and Utilization Project's National Inpatient Sample, patients admitted to the hospital from April to December 2020 with a diagnosis of COVID-19 infection were identified by the World Health Organization's International Statistical Classification of Diseases and Related Health Problems, Tenth Revision code U07.
Background: Malignant sex cord-stromal cell tumours (SCST) account for only 7% of ovarian malignancies. The Arbeitsgemeinschaft fuer Gynaekologische Onkologie (AGO) study group has established a clinicopathological database to provide an overview of the current treatment strategies and survival of SCST patients and to identify research needs.
Methods: Twenty centres provided mixed retro- and prospective data of patients with tumour specimens and second-opinion pathology review treated between 2000 and 2014.