Geburtshilfe Und Frauenheilkunde最新文献

{"title":"Update Gynecologic Malignancies 2025 - Expert Opinion on Systemic Therapy for Early and Advanced Gynecological Cancers.","authors":"Julius Emons, Julia Gocke, Carla Schulmeyer, Frederik Alexander Stübs, Annika Krückel, Niklas Amann, Matthias W Beckmann, Manuel Hörner, Patrik Pöschke","doi":"10.1055/a-2622-0684","DOIUrl":"10.1055/a-2622-0684","url":null,"abstract":"<p><p>There have been major changes in the understanding of gynecologic malignancies in recent years, leading to new therapy options and subsequently to greater responsibilities for every professional treating those patients. The most significant therapeutic advances were achieved with checkpoint inhibitors (CPI), especially for endometrial and cervical cancer. In ovarian cancer the dominant and most important new substances are poly (ADP-ribose) polymerase inhibitors (PARPi). This review aims to summarize the latest studies and developments in the therapeutic landscape of endometrial, ovarian, and cervical cancer. The treatment of advanced endometrial cancer has changed significantly with the introduction of CPI such as dostarlimab (RUBY trial), durvalumab (DUO-E trial) and pembrolizumab (Keynote-868 trial). For ovarian cancer PARPi have shown substantial PFS benefits in key approval trials, including PRIMA for niraparib, PAOLA for olaparib, and ATHENA-MONO for rucaparib. These findings have established PARPi as the standard of care in maintenance therapy. Overall survival (OS) data for PRIMA and PAOLA are now available and are analyzed and placed into context in this article. Furthermore, mirvetuximab soravtansine is the first antibody-drug conjugate (ADC) approved in Germany for platinum-resistant ovarian cancer for patients with folate receptor alpha expression. The Keynote-A18 and BEATcc trials have opened new options for the utilization of immuno-oncology in cervical cancer treatment. Along with new therapeutic options, new biomarkers have also become part of daily clinical practice as predictive and prognostic factors as well as forming the basis for targeted personalized medicine. The use of CPI is revolutionizing the treatment of all gynecologic cancers and offers significant benefits for progression-free survival (PFS) and OS in most therapy regimens. With the increased use of ADCs, this is not the end of these developments. Therapy algorithms from a certified German oncology center are developed and presented in this article.</p>","PeriodicalId":12481,"journal":{"name":"Geburtshilfe Und Frauenheilkunde","volume":"85 7","pages":"736-745"},"PeriodicalIF":2.4,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12208721/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144539845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment of Patients with Early Breast Cancer: 19th St. Gallen International Breast Cancer Consensus Discussed against the Background of German Treatment Recommendations.","authors":"Michael Untch, Maggie Banys-Paluchowski, Sara Y Brucker, Carsten Denkert, Peter A Fasching, Renate Haidinger, Nadia Harbeck, Wolfgang Janni, David Krug, Sibylle Loibl, Diana Lüftner, Laura Michel, Eva Schumacher-Wulf, Christine Solbach, Rachel Würstlein, Jens Huober, Nina Ditsch","doi":"10.1055/a-2612-3790","DOIUrl":"10.1055/a-2612-3790","url":null,"abstract":"<p><p>This year's 19th St. Gallen (SG) consensus conference on the treatment of patients with early breast cancer (SGBCC: St. Gallen Breast Cancer Conference) is based on numerous patient examples, each with different variables, to reflect the increasingly personalized treatment decision for early breast cancer. More than ever, not only breast cancer subtype, performance status, age and life expectancy are considered as individual factors, but various molecular and genetic variables are also part of the treatment decision. In this manuscript, the SGBCC voting results are discussed by a German group of breast cancer specialists in the context of the recently (2025) updated treatment recommendations of the Commission of the Gynecological Oncology Working Group (AGO Mamma). The German treatment recommendations are based on current evidence. As the international panel of the SGBCC consists of experts from different countries and disciplines, the votes represent an international cross-section of opinions. Therefore, it is useful to discuss the voting results with respect to current German treatment guidelines.</p>","PeriodicalId":12481,"journal":{"name":"Geburtshilfe Und Frauenheilkunde","volume":"85 7","pages":"677-693"},"PeriodicalIF":2.4,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12208719/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144539844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Revisiting Genomic Instability, Tumor Microenvironment and Immune Response in High-Grade Serous Ovarian Cancer.","authors":"Leonie Ratz, Sunhwa Baek, Stephanie Panier","doi":"10.1055/a-2613-0489","DOIUrl":"10.1055/a-2613-0489","url":null,"abstract":"<p><p>High-grade serous tubo-ovarian cancer is the most common and aggressive type of ovarian cancer characterized by extensive genomic instability and marked inter- and intra-patient tumor heterogeneity. Tumor-site specific signaling crosstalk between cancer cells and the tumor microenvironment influences different tumor ecosystems that drive therapy response and disease progression. Cancer cell-intrinsic genomic aberrations further contribute to the diversity of the tumor immune landscape. Homologous recombination deficiency is considered a key oncogenic driver in 50% of the cases underlying distinctive mechanisms of tumor evolution. The heterogenous character of the tumor microenvironment represents a major challenge to identify predictive biomarkers of therapy response and to stratify subgroups amenable to immunotherapies.</p>","PeriodicalId":12481,"journal":{"name":"Geburtshilfe Und Frauenheilkunde","volume":"85 7","pages":"694-709"},"PeriodicalIF":2.4,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12208723/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144539833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Adjuvant Targeted Treatment of Early Hormone Receptor-positive HER2-negative Breast Cancer: Olaparib, Abemaciclib or Ribociclib - Which One, How and For Whom?","authors":"Stefan Lukac, Kerstin Pfister, Henning Schäffler, Elena Leinert, Angelina Fink, Brigitte Rack, Visnja Fink, Wolfgang Janni, Sabine Heublein","doi":"10.1055/a-2617-2084","DOIUrl":"https://doi.org/10.1055/a-2617-2084","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1055/a-2562-8469.].</p>","PeriodicalId":12481,"journal":{"name":"Geburtshilfe Und Frauenheilkunde","volume":"85 6","pages":"e2"},"PeriodicalIF":2.4,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12158537/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144283361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Minimally Invasive Surgery in Endometrial Cancer: Superior for Low-Risk and Comparable for High-Risk Cases in a 20-Year Cohort Study.","authors":"Valentina Auletta, Maya Ehab Hassan, Angela Kather, Nikolaus Gaßler, Davit Bokhua, Ingo B Runnebaum","doi":"10.1055/a-2589-0498","DOIUrl":"10.1055/a-2589-0498","url":null,"abstract":"<p><strong>Objective: </strong>Minimally invasive surgery (MIS) to treat endometrial cancer offers advantages over laparotomy, although concerns about its oncological safety for high-risk tumors and feasibility in patients with significant comorbidities remain. This study evaluates perioperative and long-term outcomes of MIS versus open surgery in a tertiary referral center cohort, using FIGO 2010 and 2023 classifications.</p><p><strong>Methods: </strong>This is a retrospective analysis of perioperative outcomes, recurrence rates, and survival after endometrial cancer surgery (2000-2021) at an ESGO training center and tertiary referral center in Germany. 760 patients underwent hysterectomy, and adequate data for risk classification (without molecular diagnostics) was available for 330 of them.</p><p><strong>Results: </strong>More than one third of the patients were aged 70 years or older and approximately half of the patients were obese. A high proportion presented with comorbidities such as hypertension or diabetes. MIS demonstrated favorable perioperative results in both low-risk and high-risk patients. Survival analysis showed a superior outcome with MIS for low-risk (5-year RFS rate: 79.8% vs. 59.2%, p = 0.035; OS rate: 83.8% vs. 58.0%, p = 0.010) and FIGO 2023 stage I disease (OS: p = 0.014). The oncological safety of MIS was equivalent to that of open surgery for high-risk tumors (5-year RFS rate: 60.5% vs. 54.3%, p = 0.506; OS rate: 67.5% vs. 58.3%, p = 0.416) and FIGO 2023 stages II (RFS, p = 0.453; OS, p = 0.378) and III (RFS, p = 0.419; OS, p = 0.850).</p><p><strong>Conclusion: </strong>MIS was found to have superior outcomes for low-risk endometrial cancer and a comparable safety for high-risk patients, including those with older age or significant comorbidities. These findings support the use of MIS approaches as viable options across diverse risk groups, in line with FIGO 2023.</p>","PeriodicalId":12481,"journal":{"name":"Geburtshilfe Und Frauenheilkunde","volume":"85 7","pages":"724-735"},"PeriodicalIF":2.4,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12208720/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144539832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of Baseline Characteristics and Therapeutic Management Strategies in Metastatic Cervical Cancer in Germany: A Multicentric Retrospective Longitudinal Observational Study: A Quality Assurance Initiative of the AGO-Study Group and AGO-OK Uterus.","authors":"Dominik Denschlag, Bastian Czogalla, Florian Heitz, Markus Kerkmann, Laura-Christin Fangmann, Philip H Klecker, Frederik A Stuebs, Linn Wölber, Julia Radosa, Pia C Lodde, Stephan Seitz, Christian George, Pawel Mach, Angelina Fink, Davit Bokhua, Nikolaus deGregorio, Björn Lampe, Franziska Hemptenmacher, Verena Friebe, Markus Fleisch, Pauline Wimberger, Anna Jaeger, Andreas Schnelzer, Suzana Mittelstadt, Dominik Ratiu, Michael Eichbaum, Adriana Haus, Matthias Kalder, Beyhan Ataseven, Willibald Schröder, Holger Bronger, Jens Kosse, Uwe Andreas Ulrich, Gabriele Elser, Philipp Harter","doi":"10.1055/a-2520-5736","DOIUrl":"10.1055/a-2520-5736","url":null,"abstract":"<p><strong>Introduction: </strong>Real-world data on treatment patterns and outcomes in recurrent or metastatic cervical cancer (r/mCC) are lacking.</p><p><strong>Methods: </strong>This first national quality assurance initiative was a retrospective analysis of patients with r/mCC diagnosed between 2018 and 2022, who were identified from medical records of 31 gynecologic cancer centers in Germany. Patient demographic and clinical characteristics, treatment patterns, and clinical outcomes were assessed descriptively. Progression-free (PFS) and overall survival (OS) were calculated using Kaplan-Meier analysis.</p><p><strong>Results: </strong>A total of 503 eligible patients (median age 55 years) were analyzed for r/mCC. 276/503 patients (55%) received first-line (1L) chemotherapy (platinum combination: 247/276; 79%) followed by targeted antibody therapy with bevacizumab (177/247; 72%), immunotherapy (19/247; 8%), or both combined (50/247; 20%). 111/503 (22%) received chemotherapy only (platinum combination: 64/111; 58%, platinum mono: 35/111; 31%, or platinum-free: 12/111; 11%), and 110/503 (22%) did not receive any systemic treatment (the remaining 6/503 patients received immunotherapy only). For these subgroups after a median follow-up of 16 months, the PFS was 12 months (95% CI 11-14), 8.8 months (95% CI 7.1-11), and 3 months (95% CI 2.3-4.8), and OS was 25 months (95% CI 21-31), 17 months (95% CI 14-22), and 3.6 months (95% CI 2.8-5.3), respectively. 176/283 (62%) patients who developed progressive disease (PD) were treated with second-line (2L) therapy.</p><p><strong>Conclusion: </strong>Only half of the patients with r/mCC were treated 1L with platinum-combination therapy including antibody therapy according to national guidelines. Moreover, 22% at initial diagnosis and 38% of patients at PD were not treated with systemic therapy at all. This might reflect poor general performance status, patients' preference, and/or lack of effective therapies especially in 2L treatment.</p>","PeriodicalId":12481,"journal":{"name":"Geburtshilfe Und Frauenheilkunde","volume":"85 5","pages":"520-532"},"PeriodicalIF":2.4,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12081097/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093303","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Update Breast Cancer 2024 Part 3 - Patients with Advanced Stage Breast Cancer.","authors":"Diana Lüftner, Hans-Christian Kolberg, Andreas D Hartkopf, Tanja N Fehm, Manfred Welslau, Volkmar Müller, Florian Schütz, Peter A Fasching, Christian Jackisch, Frederik Marme, Katharina Keller, Manuel Hörner, Chloë Goossens, Erik Belleville, Michael Untch, Marc Thill, Hans Tesch, Nina Ditsch, Julia C Radosa, Maggie Banys-Paluchowski, Achim Wöckel, Nadia Harbeck, Elmar Stickeler, Rupert Bartsch, Bahriye Aktas, Andreas Schneeweiss, Johannes Ettl, Florin-Andrei Taran, Wolfgang Janni, Rachel Würstlein, Michael P Lux","doi":"10.1055/a-2515-2366","DOIUrl":"10.1055/a-2515-2366","url":null,"abstract":"<p><p>The use of CDK4/6 inhibitors, the new PI3K/AKT-kinase inhibitors, selective estrogen receptor-degraders (SERDs), antibody-drug conjugates, immune therapies and PARP inhibitors in recent years has resulted in a marked change in the therapy landscape for patients with advanced stage breast cancer. CDK4/6 inhibitors, trastuzumab deruxtecan, and sacituzumab govitecan have all been shown to provide significant overall survival benefits compared to conventional chemotherapy. Other substances are also showing promising results and hold out the hope that further analysis of the overall survival benefits will be available in the near future. The speed at which studies are now being carried out has markedly increased, and conferences and specialist journals are now constant sources of new information. This review summarizes the most recent publications and conference presentations on the treatment of patients with advanced stage breast cancer.</p>","PeriodicalId":12481,"journal":{"name":"Geburtshilfe Und Frauenheilkunde","volume":"85 5","pages":"507-519"},"PeriodicalIF":2.4,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12081098/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"First Analysis of the Incidence of Serous Tubal Intraepithelial Carcinoma (STIC) in Germany - Evaluation of the Cancer Registry of the Federal State of Rhineland-Palatinate from 2016 to 2023.","authors":"Valerie Catherine Linz, Alina Breuer, Philipp Leppert, Nils Herm-Stapelberg, Katja Schwarzer, Annette Hasenburg","doi":"10.1055/a-2555-4602","DOIUrl":"10.1055/a-2555-4602","url":null,"abstract":"<p><strong>Introduction: </strong>Serous tubal intraepithelial carcinomas (STIC) are classified as precursor lesions of high-grade serous carcinomas (HGSC) in women. STIC are rare and their incidence, prognosis and therapy remain unclear. Since 2021, all cases of isolated STIC in Germany must be reported, which means that all STICs in the German federal state of the Rhineland-Palatine (RLP) are available for evaluation.</p><p><strong>Material and methods: </strong>A systematic search of the pathology reports in the RLP cancer registry was carried out for the period 01/2016-12/2023 using keywords related to STIC, and the results of the search were evaluated.</p><p><strong>Results: </strong>382 pathology reports were identified as relevant and screened. A total of seven patients with isolated STIC were reported to the RLP registry in the years 2020-2022. This corresponds to 0.014% of all reported cases of cancer in women in RLP in this period. Six patients had a diagnosis of isolated STIC, identified during risk-reducing salpingo-oophorectomy (RRSO). The mean patient age at the time of RRSO was 60.29 (± 7.09) years. RRSO was carried out on average 9.38 (± 6.75) years after a primary diagnosis of breast cancer/DCIS in five patients. No HGSC was reported for any of the patients with isolated STIC in the follow-up period until 01/2024. 43 synchronous STICs were reported for the period from 01/2016 to 12/2023.</p><p><strong>Conclusion: </strong>2-3 diagnoses of isolated STIC were recorded annually in RLP in the years 2020-2022. To date, there have been no reports of HGSC in these patients. In the future, the systematic recording of STICs will be expanded to include the cancer registries of other federal states of Germany and it will be possible to obtain valid data on the incidence of STIC in Germany. The collected data will also provide the basic information for a national STIC registry.</p>","PeriodicalId":12481,"journal":{"name":"Geburtshilfe Und Frauenheilkunde","volume":"85 5","pages":"541-547"},"PeriodicalIF":2.4,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12081095/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the editor on \"Effects of Systematically Guided vs. Self-Directed Laparoscopic Box Training on Learning Performances\".","authors":"Florian Recker, Ricarda Neubauer","doi":"10.1055/a-2539-5940","DOIUrl":"10.1055/a-2539-5940","url":null,"abstract":"","PeriodicalId":12481,"journal":{"name":"Geburtshilfe Und Frauenheilkunde","volume":"85 5","pages":"548-550"},"PeriodicalIF":2.4,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12081093/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Update Breast Cancer 2024 Part 2 - Patients with Early Stage Breast Cancer.","authors":"Wolfgang Janni, Hans-Christian Kolberg, Andreas D Hartkopf, Tanja N Fehm, Manfred Welslau, Volkmar Müller, Florian Schütz, Peter A Fasching, Christian Jackisch, Frederik Marme, Manuel Hörner, Katharina Keller, Chloë Goossens, Erik Belleville, Michael Untch, Marc Thill, Hans Tesch, Nina Ditsch, Michael P Lux, Maggie Banys-Paluchowski, Achim Wöckel, Nadia Harbeck, Elmar Stickeler, Rupert Bartsch, Bahriye Aktas, Andreas Schneeweiss, Johannes Ettl, Florin-Andrei Taran, Diana Lüftner, Rachel Würstlein, Julia C Radosa","doi":"10.1055/a-2533-2783","DOIUrl":"10.1055/a-2533-2783","url":null,"abstract":"<p><p>This review summarizes the latest developments for the treatment of patients with early-stage breast cancer. Most of the clinically relevant changes were the result of using immune checkpoint inhibitors to treat patients with triple-negative breast cancer (TNBC) and CDK4/6 inhibitors to treat patients with hormone receptor-positive, HER2-negative (HRpos/HER2neg) tumors and a high risk of recurrence. Recent studies are presenting more and more data with long follow-up times and integrating translational analyses to evaluate new biomarkers such as circulating tumor DNA (ctDNA). This review article summarizes the latest developments published in recent months and puts the findings in context.</p>","PeriodicalId":12481,"journal":{"name":"Geburtshilfe Und Frauenheilkunde","volume":"85 5","pages":"493-506"},"PeriodicalIF":2.4,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12081099/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}