Publications by authors named "Schiffmann L"
Purpose: The management of soft tissue sarcoma (STS) at reference centers with specialized multidisciplinary tumor boards (MTB) improves patient survival. The German Cancer Society (DKG) certifies sarcoma centers in German-speaking countries, promoting high standards of care. This study investigated the variability in treatment recommendations for localized STS across different German-speaking tertiary sarcoma centers.
View Article and Find Full Text PDFThis study evaluates the H2AX/γ-H2AX expression in soft tissue sarcomas (STS), its implications for biological behavior and immune environment, and its potential as a prognostic biomarker. RNA-Seq data from 237 STS were obtained from The Cancer Genome Atlas project. Patients were stratified by H2AX mRNA expression using a survival-associated cutoff.
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- The study explores the effectiveness of different treatment strategies for patients with metastatic oesophageal cancer, highlighting the potential benefits of multimodal therapy, including surgery, over traditional systemic approaches.
- A total of 235 patients who underwent the Ivor Lewis oesophagectomy were analyzed, revealing that those who received surgery or multimodal treatment had significantly better overall survival rates (19.0 and 18.0 months) compared to those treated with chemotherapy alone (11.0 months).
- The findings suggest that surgical intervention, whether standalone or part of a multimodal approach, could be an important factor for improving survival outcomes in selected patients with metastatic oesophageal cancer.
Importance: There is a lack of trials examining the effect of counseling interventions for child, adolescent, and younger adult (CAYA) cancer survivors.
Objective: To assess lifestyle habits and the psychosocial situation of CAYAs to determine the efficacy of needs-based interventions in the CARE for CAYA program (CFC-P).
Design, Setting, And Participants: The CFC-P was conducted as a multicenter program in 14 German outpatient clinics, mainly university cancer centers.
Previous studies have shown that surgical residents can safely perform a variation of complex abdominal surgeries when provided with adequate training, proper case selection, and appropriate supervision. Their outcomes are equivalent when compared to experienced board-certified surgeons. Our previously published training curriculum for robotic assisted minimally invasive esophagectomy already demonstrated a possible reduction in time to reach proficiency.
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- The ISCON trial investigated the effects of ischemic conditioning (ISCON) on patients undergoing Ivor-Lewis esophagectomy, particularly those at risk for anastomotic leakage due to vascular issues.
- The study included 20 esophageal cancer patients, collecting serum samples and gastric biopsies to measure changes in vascularization and cytokine levels before and after the ISCON procedure.
- Results showed that while serum cytokine levels did not change, biopsies indicated a significant increase in microvascular density in the gastric tissue, suggesting improved blood supply at the anastomotic site following ISCON.
Article Synopsis
- cIAPs are proteins that play a crucial role in regulating TNF signaling by modifying RIPK1, and mutations in cIAP1/2 lead to severe embryonic development issues in mice due to apoptosis.
- While a modified version of RIPK1 can rescue embryonic development, its absence in cIAP1/2 mice results in inflammation and early death after weaning.
- The study reveals that cIAPs also control TNFR1-mediated toxicity independently of RIPK1 and RIPK3, providing new insights into TNF signaling and creating a mouse model to help evaluate treatments involving TNF inhibitors.
Introduction: The demand for complementary medicine (CM) is well studied in the outpatient sector, but representative data on type and extent of inpatient care using CM are missing. Therefore, our aim was to examine the range of CM treatments offered and the types of indications for using CM in acute care hospitals in the German state of Bavaria.
Methods: We conducted a cross-sectional questionnaire survey by contacting the medical heads of all 388 Bavarian acute care hospitals between November 2020 and April 2021.
A convolutional neural network for bleeding detection in capsule endoscopy using real clinical data.
Minim Invasive Ther Allied Technol
December 2023
Article Synopsis
- * Researchers analyzed videos for 125 bleeding episodes and 103 normal tissues, using a neural network model (Inception V3) that leveraged transfer learning for training.
- * The CNN achieved a detection accuracy of 90.6%, indicating it could enhance diagnostic speed and accuracy in clinical settings for interpreting capsule endoscopy results.
Background: This case report demonstrates the simultaneous development of a gastrointestinal stromal tumour (GIST) with arteriovenous malformations (AVMs) within the jejunal mesentery. A 74-year-old male presented to the department of surgery at our institution with a one-month history of abdominal pain. Contrast-enhanced computed tomography revealed an AVM.
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- Robotic-assisted minimally invasive esophagectomy (RAMIE) has improved postoperative recovery since its introduction in 2003, and this study aimed to evaluate a proficiency-based training pathway for surgeons at a high-volume center in Germany.
- A total of 154 patients who underwent RAMIE between 2017 and 2022 were analyzed to observe the necessary case numbers for surgeons to reach expert performance levels in various metrics such as operating time and complication rates.
- Results indicated that significant improvements in surgical performance were seen after specific case milestones, with varying stabilization points for hospital stay and anastomotic leak rates, highlighting the importance of structured training in developing surgical expertise.
Introduction: National and international guidelines recommend early integration of evidence-based multimodal interventions and programs, especially with a focus on relaxation techniques and other Mind-Body-based methods to maintain the quality of life of oncology patients, improve treatment tolerability, and promote healthy lifestyle behaviors. Consequently, we aim to understand what drives patients and how they navigate integrative medicine to best advise them. This study aimed to detect possible topics of particular interest to patients and identify the patient groups that could benefit most from further programs.
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- Anastomotic leakage (AL) is a common and serious complication after Ivor-Lewis esophagectomy, and this study analyzes a new classification system for managing AL based on treatment options.
- The study examined 954 patients, revealing that most leaks were type II (endoscopic intervention), with type III (surgical intervention) being diagnosed earlier but associated with higher organ failure rates.
- The researchers concluded that while the new classification is easy to use and helps differentiate severity, it doesn't provide a clear treatment algorithm for managing AL.
Article Synopsis
- The study explores the use of near-infrared light fluorescence (NIR) with indocyanine green (ICG) for mapping lymph nodes during esophageal cancer surgery, a method not yet established in this field.
- It involved 20 patients with advanced esophageal cancer undergoing robotic-assisted minimally invasive esophagectomy (RAMIE), where ICG was injected around the tumor prior to surgery to visualize lymphatic drainage.
- Initial findings indicate that using NIR imaging is feasible and safe for detecting lymph node metastases during RAMIE, with plans for further research on ICG-positive tissue and long-term outcomes.
Article Synopsis
- - Anastomotic leakage (AL) is a serious complication following esophagectomy, and ischemic conditioning (ISCON) of the stomach may decrease its occurrence when performed 14 days prior to surgery.
- - A multicenter trial assessed the safety and feasibility of laparoscopic ISCON in patients with esophageal cancer who are at high risk for AL, showing that the procedure had no major complications and a short hospital stay.
- - Of the 20 patients treated, AL occurred in just 15%, and no mortality was observed within 90 days post-surgery; further research is needed to confirm whether ISCON significantly lowers AL rates.
Background: Histopathologic regression following neoadjuvant treatment (NT) of oesophageal cancer is a prognostic factor of survival, but the nodal status is not considered. Here, a score combining both to improve prediction of survival after neoadjuvant therapy is developed.
Methods: Seven hundred and fifteen patients with oesophageal squamous cell (SCC) or adenocarcinoma (AC) undergoing NT and esophagectomy were analysed.
Background: Low anterior resection for rectal cancer is commonly associated with a diverting stoma. In general, the stoma is closed 3 months after the initial operation. The diverting stoma reduces the rate of anastomotic leakage as well as the severeness of a potential leakage itself.
View Article and Find Full Text PDFBackground: In Germany, complementary medicine is used by up to 62% of patients, but type and extent of in-patient complementary care are not known. The objective of this study was, therefore, to conduct a survey on complementary medicine procedures in Bavarian acute care hospitals by screening the websites of all respective facilities in order to cover a broad range of complementary procedures.
Methods: In 2020, an independent and comprehensive website screening of all 389 Bavarian acute hospitals, including all departments, was conducted by two independent raters.
Purpose: Pancreatic ductal adenocarcinoma (PDAC) is currently one of the leading causes of cancer death worldwide. Therefore, building further subgroups as well as enabling individual patient therapy and diagnostics are needed. X-linked inhibitor of apoptosis protein (XIAP) is known to modulate apoptotic and inflammatory pathways.
View Article and Find Full Text PDFIntroduction: Malnutrition in cancer patients often remains undetected and underestimated in clinical practice despite studies revealing prevalences from 20 to 70%. Therefore, this study aimed to identify patient groups exposed to an increased nutritional risk in a university oncological outpatient center.
Methods: Between May 2017 and January 2018 we screened oncological patients there using the malnutrition universal screening tool (MUST).