L Hefler

Karl Landsteiner Institut, Wien, Vienna, Austria

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Publications (241)758.54 Total impact

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    ABSTRACT: The aim of the present study was to assess if semen quality declines during in vitro fertilization (IVF) and whether or not this phenomenon is triggered by chronic male stress. In order to test this hypothesis, we first investigated a retrospective cohort of 155 male IVF patients (testing cohort). Subsequently, we started a prospective cohort study in men undergoing their first IVF and assessed semen quality and subjective male chronic stress using a validated tool, i.e. the Fertility Problem Inventory (FPI) questionnaire. The association between stress and sperm quality decline measured 4-6 weeks before the start of IVF (T1) and at the day of oocyte retrieval (T2) was the primary outcome. Live birth rate, first trimester abortion and rate of poor responders were secondary outcomes. In the testing cohort, mean progressive motility, but not mean sperm density significantly declined. There were 78/154 (51%) men who showed a decline in semen density and 50/154 (32%) men who showed a decline in progressive motility. In the validation cohort, progressive motility declined, whereas, sperm density increased from T1 to T2. Of 78 men, 27 men had increased stress (FPI-score > 146). Sperm density and progressive motility were not significantly different in men with and without stress. However, in the presence of male stress, couples had a higher rate of poor responders, miscarriages and a lower rate of live births. Subjective stress is not associated with a decline in semen quality observed during IVF but may be associated with adverse pregnancy outcome.
    Asian Journal of Andrology 03/2014; · 2.14 Impact Factor
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    ABSTRACT: To compare the skills of performing a vaginal breech (VB) delivery after hands-on training versus demonstration. We randomized medical students to a 30-min demonstration (group 1) or a 30-min hands-on (group 2) training session using a standardized VB management algorithm on a pelvic training model. Subjects were tested with a 25 item Objective Structured Assessment of Technical Skills (OSATS) scoring system immediately after training and 72h thereafter. OSATS scores were the primary outcome. Performance time (PT), self assessment (SA), confidence (CON), and global rating scale (GRS) were the secondary outcomes. Statistics were performed using the Mann-Whitney U-test, chi-square test, and multiple linear regression analysis. 172 subjects were randomized. OSATS scores (primary outcome) were significantly higher in group 2 (n=88) compared to group 1 (n=84) (21.18±2.29 vs. 20.19±2.37, respectively; p=0.006). The secondary outcomes GRS (10.31±2.28 vs. 9.17±2.21; p=0.001), PT (214.60±57.97s vs. 246.98±59.34s; p<0.0001), and CON (3.14±0.89 vs. 2.85±0.90; p=0.04) were also significantly different between groups, favoring group 2. After 72h, primary and secondary outcomes were not significantly different between groups. In a multiple linear regression analysis, group assignment (odds ratio [OR] 1.60; 95% confidence interval [CI] 1.14-2.05; p<0.0001) and gender (OR 2.91; 95% CI 2.45-3.38; p<0.0001) independently influenced OSATS scores. Hands-on training leads to a significant improvement of VB management in a pelvic training model, but this effect was only seen in the short term.
    European journal of obstetrics, gynecology, and reproductive biology 09/2013; · 1.97 Impact Factor
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    ABSTRACT: Hypoalbuminemia, a known marker for malnutrition and increased morbidity and mortality, has been associated with impaired prognosis in different cancer entities. The present study investigates the prognostic value of pre-treatment serum albumin levels for survival in patients with endometrial cancer. Within the present cohort study, we evaluated 337 consecutive patients with endometrial cancer and investigated the association of pre-treatment serum albumin levels and clinical-pathological parameters. We performed univariate log-rank tests and multivariable Cox regression models to assess the association between pre-treatment serum albumin levels and survival. Pre-treatment serum albumin levels were inversely proportionally associated with FIGO tumor stage, histological grade, and patients' age. In a multivariable analysis pre-treatment serum albumin levels (p=0.02 and p=0.001), FIGO tumor stage (p<0.001 and p<0.001), and histological grade (p=0.002 and p<0.001) were independently associated with disease-free and progression-free survival, respectively. Pre-treatment serum albumin is a novel and independent prognostic parameter for disease-free and progression-free survival in patients with endometrial cancer.
    European journal of obstetrics, gynecology, and reproductive biology 08/2013; · 1.97 Impact Factor
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    ABSTRACT: OBJECTIVE: Endometriotic spread to the lymphatic system has been described, but little is known about the molecular events and changes in gene expression associated with this process. We sought to determine the expression levels of a panel of 28 genes in samples of primary endometriosis lesions (EL), isolated endometriotic-like cells (IELC)-positive pelvic sentinel lymph nodes (PSLN), and IELC-negative PSLN, in order to identify candidate genes that may play a role in this process. STUDY DESIGN: Quantitative real-time PCR and immunohistochemistry (IHC) of primary EL and PSLN samples with and without IELC from patients with ovarian and/or peritoneal endometriosis. RESULTS: Gene expression was analyzed in EL (n=13), IELC-positive PSLN (PSLN+, n=11), and IELC-negative PSLN (PSLN-, n=8). Gene expression differences between PSLN+ and PSLN- were analyzed and evaluated in relation to their expression levels in EL. Genes expressed at high levels in EL but not in PSLN- and known to be expressed in IELC (such as ESR1, PGR) served as controls and the expected gene dilution effect was clearly observed. Expression of a set of genes (CXCR4, CD68, MKI67, and CD44) was found to be higher in PSLN+ vs. PSLN-, while lowest in EL, indicating upregulation in IELC. In contrast, EPCAM and E-cadherin, which were strongly expressed in EL, were not found to be expressed in PSLN+, and thus likely absent from IELC. IHC confirmed the expression of CXCR4, CD44s, and CD44v6 in IELC, as well as the absence of E-cadherin from IELC. CONCLUSION: Our data indicate that spread of endometriosis to PSLN is accompanied by differential expression of several genes, including EPCAM, CDH1 (E-cadherin), CXCR4, and CD44, suggesting an involvement of CD44 splice variants as well as CXCR4 signalling in this process.
    European journal of obstetrics, gynecology, and reproductive biology 04/2013; · 1.97 Impact Factor
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    ABSTRACT: : To compare the skills of performing a shoulder dystocia management algorithm after hands-on training compared with demonstration. : We randomized medical students to a 30-minute hands-on (group 1) and a 30-minute demonstration (group 2) training session teaching a standardized shoulder dystocia management scheme on a pelvic training model. Participants were tested with a 22-item Objective Structured Assessment of Technical Skills scoring system after training and 72 hours thereafter. Objective Structured Assessment of Technical Skills scores were the primary outcome. Performance time, self-assessment, confidence, and global rating scale were the secondary outcomes. Statistics were performed using Mann-Whitney U test, χ test, and multiple linear regression analysis. : Two hundred three participants were randomized. Objective Structured Assessment of Technical Skills scores were significantly higher in group 1 (n=103) compared with group 2 (n=100) (17.95±3.14 compared with 15.67±3.18, respectively; P<.001). The secondary outcomes global rating scale (GRS; 10.94±2.71 compared with 8.57±2.61, respectively; P<.001), self-assessment (3.15±0.94 compared with 2.72±1.01; P=.002), and confidence (3.72±0.98 compared with 3.34±0.90, respectively; P=.005), but not performance time (3:19±0:48 minutes compared with 3:31±1:05 minutes; P=.1), were also significantly different, favoring group 1. After 72 hours, Objective Structured Assessment of Technical Skills scores were still significantly higher in group 1 (n=67) compared with group 2 (n=60) (18.17±2.76 compared with 14.98±3.03, respectively; P<.001) as were GRS (10.80±2.62 compared with 8.15±2.59; P<.001) and self assessment (SA; 3.44±0.87 compared with 2.95±0.94; P=.003). In a multiple linear regression analysis, group assignment (group 1 compared with 2; P<.001) and sex (P=.002) independently influenced Objective Structured Assessment of Technical Skills scores. : Hands-on training helps to achieve a significant improvement of shoulder dystocia management on a pelvic training model. : www.ClinicalTrials.gov, NCT01618565. : I.
    Obstetrics and Gynecology 10/2012; 120(4):809-14. · 4.80 Impact Factor
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    ABSTRACT: Alternatives to surgical therapy are needed for the treatment of high-grade cervical intraepithelial neoplasia (CIN 2-3). We aimed to estimate the efficacy of a treatment with imiquimod, a topical immune-response modulator, in patients with CIN 2-3. Fifty-nine patients with untreated CIN 2-3 were randomly allocated to a 16-week treatment with self-applied vaginal suppositories containing either imiquimod or placebo. The main outcome was efficacy, defined as histologic regression to CIN 1 or less after treatment. Secondary outcomes were complete histologic remission, human papillomavirus (HPV) clearance, and tolerability. Assuming a two-sided 5% significance level and a power of 80%, a sample size of 24 patients per group was calculated to detect a 35% absolute increase in CIN 2-3 regression. Histologic regression was observed in 73% of patients in the imiquimod group compared with 39% in the placebo group (P=.009). Complete histologic remission was higher in the imiquimod group (47%) compared with the placebo group (14%) (P=.008). At baseline, all patients tested positive for high-risk HPV. Human papillomavirus clearance rates were increased in the imiquimod group (60%) compared with the placebo group (14%) (P<.001). In patients with HPV-16 infection, complete remission rates were 47% in the imiquimod group compared with 0% in the placebo group (P=.003). Microinvasive cancer was observed in three of 59 (5% [1-14%]) patients, all within the placebo group. Topical imiquimod treatment was well tolerated, and no high-grade side effects were observed. Topical imiquimod is an efficacious and feasible treatment for patients with CIN 2-3.
    Obstetrics and Gynecology 07/2012; 120(1):152-9. · 4.80 Impact Factor
  • Geburtshilfe und Frauenheilkunde 04/2012; 72(04). · 0.85 Impact Factor
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    ABSTRACT: To investigate the association between plasma fibrinogen levels and clinico-pathological parameters of patients with vulvar cancer and to determine their value as prognostic parameters. In this retrospective study, we evaluated pretreatment plasma fibrinogen levels in 120 patients with invasive squamous cell vulvar cancer and correlated them with clinico-pathological parameters and patients' survival. Pretreatment plasma fibrinogen levels were directly associated with tumor stage (pT1a vs. pT1b vs. pT2 vs. pT3-4, p=0.001), lymph node involvement (pN0 vs. pN1, p=0.04), and histological grade (G1 vs. G2 vs. G3, p=0.03), but not with patients' age (≤ 70 years vs. >70 years, p=0.6). In a multivariate survival analysis, tumor stage (p=0.006/p=0.02) and lymph node involvement (p<0.001/p<0.001), but neither histological grade (p=0.2/p=0.9) nor plasma fibrinogen levels (p=0.6/p=0.6) were associated with disease-free and overall survival, respectively. In a multivariate analysis, patient's age (≤ 70 years vs. >70 years) was associated with overall survival (p=0.03) but not with disease-free survival (p=0.1). Pretreatment plasma fibrinogen levels were directly associated with tumor stage, lymph node involvement and histological grade. Although we could demonstrate a prognostic value of pretreatment plasma fibrinogen levels on survival, we were unable to establish fibrinogen as an independent prognostic parameter in patients with vulvar cancer.
    European journal of obstetrics, gynecology, and reproductive biology 03/2012; 161(1):88-91. · 1.97 Impact Factor
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    ABSTRACT: We wanted to evaluate the feasibility and effect of a hands-on loop electrosurgical excision procedure (LEEP) 2.5-day intensive surgical skills workshop, using a novel training model on porcine tissue. Hands-on simulation-based training was conducted to emphasize colposcopy, local anesthesia, uterine cervix and vulva punch biopsy, LEEP, and complication management. Performance of 51 participants' technical skills was assessed before and after training completion. LEEP performance was significantly better after completion of the training (P < .001). Before and after training mean scores (SD) of 18.0 (3.5) and 23.4 (2.1) were assessed. Multivariate analysis revealed that the training effects were independent of previous surgical expertise. The LEEP workshop was feasible and effective and we recommend implementing hands-on LEEP training into gynecology training programs.
    American journal of obstetrics and gynecology 01/2012; 206(6):535.e1-4. · 3.28 Impact Factor
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    ABSTRACT: Breact cancer, as with most solid tumors, needs to develop the angiogenic phenotype for invasiveness, progression and metastasis. Several studies have determined that the degree of peritumoral vascularity as a marker of angiogenesis is associated with prognosis of patients operated on for early stage invasive breast cancer. Angiogenesis is regulated by a network of inducing and inhibiting factors under physiologic conditions, whereas in pathologic conditions, such regulation is altered or absent. These regulating factors include cytokines, fibrin, and integrins, among others. A number of pro-angiogenic factors have been identified, the most potent of which are vascular endothelial growth factor/ vascular permeability factor (VEGF/VPF), acidic and basic fibroblast growth factor (aFGF and bFGF) and epidermal growth factor (EGF). Vascular endothelial growth factor (VEGF) has been shown to play a major role in tumor angiogenesis and is a marker of tumor outcome and prognosis in breast cancer. In conclusion angiogenesis will be important in evaluating the risk of metastasis in breast cancer whereas angiogenesis inhibition may be important in the development of new strategies in cancer therapy.
    07/2011: pages 40-47;
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    ABSTRACT: The objective of the study was to evaluate the association between human papillomavirus (HPV) infection and clinical-pathological parameters in primary squamous cell carcinoma of the vagina and assess the value of HPV infection as a prognostic parameter. In our retrospective study, we identified 37 consecutive patients with primary invasive squamous cell carcinoma of the vagina; 35 patients were eligible for further investigations. Human papillomavirus detection was assessed by in situ hybridization assays from paraffin-embedded tissue blocks. Human papillomavirus detection was correlated with clinical-pathological parameters by χ² and Fisher exact tests. Univariate log-rank tests and multivariate Cox regression models were used to evaluate the association between HPV infection and patient survival. Human papillomavirus DNA was detected in 18 (51.4%) of 35 cases. Human papillomavirus status did no influence clinical-pathological parameters, such as clinical stage (P=0.9), grade (P=0.9), and tumor size (P=0.18). Prognosis did not significantly differ between HPV-positive and HPV-negative tumors in the entire cohort; however, patients with unfavorable tumor stage (International Federation of Gynecology and Obstetrics stage≥III) and HPV positivity had improved disease-free (P=0.004) and overall survival (P=0.023). Human papillomavirus infection was frequently detected in squamous cell carcinoma of the vagina, and its presence may serve as a prognostic indicator in advanced stages.
    International Journal of Gynecological Cancer 07/2011; 21(5):923-9. · 1.94 Impact Factor
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    ABSTRACT: C-reactive protein (CRP) is the prototypical biomarker of inflammation. Genetic variations within the CRP gene have been shown to be associated with alterations of CRP expression and prognosis in cancer patients. The purpose of this study was to evaluate the association between four polymorphisms of the CRP gene, CRP serum levels, clinicopathological parameters of cervical cancer and survival in patients with cervical cancer. The four most common single nucleotide gene polymorphisms CRP1919 (rs1417938), CRP2667 (rs1800947), CRP3872 (rs1205), and CRP5237 (rs2808630) were evaluated in 178 patients with cervical cancer. DNA was extracted from blood samples and CRP gene polymorphisms were investigated, using pyrosequencing. Findings were correlated with CRP serum levels, clinico-pathological parameters of cervical cancer, and disease-free and overall survival. Furthermore, the association between haplotype combinations and survival was investigated. Presence of the CRP gene polymorphism CRP5237A>G was associated with lower CRP serum levels (p=0.04). Univariate survival analysis revealed that CRP1919T>A polymorphism (p=0.02), International Federation of Gynecology and Obstetrics stage (p<0.001), lymph node involvement (p=0.004), histological grade (p=0.01), and serum CRP levels (p<0.001) correlate with overall survival. In the multivariable Cox regression model, CRP1919T>A (p=0.02), tumor stage (p<0.001), lymph node involvement (p=0.03), patients' age (p=0.02), and serum CRP levels (p<0.001) were found to be independently associated with overall survival. None of the haplotype combinations were associated with prognosis of patients with cervical cancer. Presence of the CRP1919T>A polymorphism was associated with impaired overall survival in patients with cervical cancer. The CRP gene polymorphism CRP5237A>G was associated with decreased serum CRP levels.
    Anticancer research 06/2011; 31(6):2259-64. · 1.71 Impact Factor
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    ABSTRACT: To evaluate the association between 3 vascular endothelial growth factor (VEGF) gene polymorphisms and susceptibility of cervical intraepithelial neoplasia (CIN). This prospectively collected case-control study investigates three common VEGF gene polymorphisms (ie, VEGF -460 [rs833061], VEGF +405 [rs2010963], and VEGF +936 [rs3025039]) in 203 women with CIN and 209 healthy women by DNA pyrosequencing. Associations between polymorphisms and CIN risk are evaluated with univariate and multivariable models and haplotype analysis. In a multivariable regression model, the variant VEGF +405C allele was associated (odds ratio [OR], 2.5; 95% confidence interval [CI], 1.2-5.1], P = 0.02) with increased susceptibility of CIN independent of number of sexual partners (OR, 2.2; 95% CI, 1.1-4.6; P = 0.03) and smoking (OR, 3.3; 95% CI, 1.6-6.6; P = 0.001). The haplotype VEGF -460C - +405C - +936C was associated with an OR of 5.2 (95% CI, 1.2-52.7) for the susceptibility of CIN. The presence of the variant VEGF +405C allele and the haplotype VEGF -460C - +405C - +936C are independently associated with higher susceptibility of CIN.
    International Journal of Gynecological Cancer 05/2011; 21(4):597-601. · 1.94 Impact Factor
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    ABSTRACT: To evaluate the association between five interleukin-1 (IL-1) and -6 gene polymorphisms and risk of high grade cervical intraepithelial neoplasia (CIN 2-3). This case-control study investigates five common IL-1 and IL-6 gene polymorphisms in 131 women with CIN 2-3 and 209 controls by pyrosequencing and polymerase chain reaction. Associations between gene polymorphisms and risk of CIN 2-3 are analysed by univariate and multivariable models. Their combined effect on the risk of CIN is evaluated by haplotype analysis. In a multivariable regression model IL1A -889 (odds ratio 0.3 [95% confidence interval 0.1-0.8], p=0.01) and smoking (4.0 [1.7-9.1], p=0.001) are independently associated with the risk of high grade CIN. Haplotype analysis does not reveal any high-risk combinations for the susceptibility of CIN. The single nucleotide polymorphism IL1A -889 is independently associated with risk of high grade CIN.
    Gynecologic Oncology 03/2011; 121(3):537-41. · 3.93 Impact Factor
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    ABSTRACT: Primary invasive squamous cell carcinoma of the vagina is a rare neoplasm. Investigations concerning the potential of new therapeutic targets are limited. A total of 34 patients with primary invasive squamous cell carcinoma of the vagina was identified, who were treated at our institution between 1994 and 2008. Epidermal growth factor receptor (EGFR) and vascular endothelial growth factor (VEGF) expression was assessed using immunohistochemistry from paraffin-embedded tissue blocks. EGFR was expressed in 33 of 34 (97.1%) and VEGF was expressed in 12 of 34 cases (35.3%). There was no statistically significant relationship between clinicopathologic parameters (clinical stage, grading, tumor size), patient survival, and EGFR and VEGF expression. VEGF was moderate and EGFR was frequently expressed in invasive squamous cell carcinoma of the vagina. In our sample size, immunohistochemical staining was not statistically significantly associated with prognosis.
    American journal of obstetrics and gynecology 02/2011; 204(2):171.e1-6. · 3.28 Impact Factor
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    ABSTRACT: To evaluate gene expression signatures of breast tissue in female-to-male (FtM) transsexuals under cross-sex hormone therapy (HT). Prospective cohort study. Academic research institution. Five hormone-naïve FtM transsexuals before and after HT. Breast tissue biopsy before and after 2 years of intramuscular testosterone undecanoate (1,000 mg every 12 wk) and oral lynestrenole (5 mg daily), and gene signature analysis by global gene expression array covering 28,869 genes. Differential regulation of specific genes and gene expression signatures. We identified 2,250 differentially expressed probe sets. One hundred twenty probe sets showed >2-fold change, of which 77 (64.2%) were up-regulated and 43 (35.8%) down-regulated. Genes involved in transcription were most overrepresented, with 43 out of 97 (44.3%) annotated probes, e.g., the transcription factor complex activator protein 1, including all three Jun genes (c-Jun, JunB, and JunD), two Fos genes (c-Fos and FosB), and activating transcription factor 3. In a Database for Annotation, Visualization, and Integrated Discovery analysis of the 2,007 down-regulated probe sets, proteins of the ribosome pathway and of two pathways involved in protein degradation, i.e., proteasome- and ubiquitin-mediated proteolysis, were significantly down-regulated. We identified eight breast cancer-associated gene expression signatures significantly overlapping with differentially regulated probe sets after cross-sex HT. Cross-sex HT in FtM transsexuals leads to the up-regulation and down-regulation of 243 and 2,007 distinct genes, respectively, and is associated with breast cancer-related gene expression signatures.
    Fertility and sterility 12/2010; 94(7):2688-96. · 3.97 Impact Factor
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    ABSTRACT: The transport protein P-glycoprotein, which is encoded by the multidrug-resistance ABCB1 gene, is crucially involved in the export of taxanes and other cytotoxic substances out of the cell. Treatment response to paclitaxel has been shown to correlate with ABCB1 gene polymorphisms. Data regarding the prognostic value of ABCB1 gene polymorphisms in ovarian cancer patients is conflicting. The present study evaluates the association of two common ABCB1 gene polymorphisms, namely G2677T/A in exon 21 (rs2032582) and C3435T in exon 26 (rs1045642), and survival in 106 Caucasian women with ovarian cancer. The two ABCB1 gene polymorphisms (G2677T/A and C3435T) were associated neither with disease-free (p=0.8 and p=0.9, respectively) nor with overall survival (p=0.9 and p=0.9, respectively). Tumor stage (p=0.01; p=0.01) and residual tumor mass (p=0.005; p=0.01), but not tumor grade and age at diagnosis were associated with disease-free and overall survival, respectively, in a multivariate analysis. Haplotype analysis did not reveal any association between the combined effect of the two gene polymorphisms and survival. In the present study, ABCB1 G2677T/A and ABCB1 C3435T gene polymorphisms were not found to be associated with prognosis in Caucasian women with ovarian cancer.
    Anticancer research 09/2010; 30(9):3487-91. · 1.71 Impact Factor
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    ABSTRACT: To evaluate the prognostic value of lymph node density (LND) in patients with lymph node-positive cervical cancer. A total of 88 consecutive patients were included in our study. Patients were treated with cisplatin-based concomitant chemoradiotherapy after surgical staging was performed at the Medical University of Vienna. Lymph node density, that is, the ratio of positive lymph nodes to the total number of lymph nodes removed, was assessed pathologically. Patients were stratified into two groups according to LND: patients with LND <or=10% and patients with LND >10%. Lymph node density was correlated with clinicopathological parameters by chi(2)-tests. Univariate log-rank tests and multivariate Cox regression models were used to evaluate the association between LND and survival. A significant correlation between LND and FIGO stage (P=0.03), but not patients' age (P=0.2), histological grade (P=0.8), and histological type (P=0.5), was observed. In a univariate survival analysis, LND (P=0.01; P=0.01), FIGO stage (P=0.01; P=0.008), and histological grade (P=0.03; P=0.04) were associated with disease-free and overall survival, respectively. Patients with LND >10% had impaired disease-free and overall survival rates compared with patients with LND <or=10%. In a multivariate regression model, LND (P=0.01; P<0.05) and FIGO stage (P=0.002; P=0.002) were independent predictors of disease-free and overall survival, respectively. LND >10% is associated with an impaired disease-free and overall survival. Lymph node density may be used as an independent prognostic parameter in patients with lymph node-positive cervical cancer.
    British Journal of Cancer 08/2010; 103(5):613-6. · 5.08 Impact Factor
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    ABSTRACT: The Glasgow Prognostic Score (GPS) is known to reflect the degree of tumor-associated cachexia and inflammation and is associated with survival in various malignancies. We investigated the value of the GPS in patients with cervical cancer. We included 244 consecutive patients with cervical cancer in our study. The pretherapeutic GPS was calculated as follows: patients with elevated C-reactive protein serum levels (>10 mg/L) and hypoalbuminemia (<35 g/L) were allocated a score of 2, and patients with 1 or no abnormal value were allocated a score of 1 or 0, respectively. The association between GPS and survival was evaluated by univariate log-rank tests and multivariate Cox regression models. The GPS was correlated with clinicopathologic parameters as shown by performing chi2 tests. In univariate analyses, GPS (P < 0.001, P < 0.001), International Federation of Gynecology and Obstetrics (FIGO) stage (P < 0.001, P < 0.001), and lymph node involvement (P < 0.001, P < 0.001), but not patients' age (P = 0.2, P = 0.07), histological grade (P = 0.08, P = 0.1), and histological type (P = 0.8, P = 0.9), were associated with disease-free and overall survival, respectively. In a multivariate analysis GPS (P = 0.03, P = 0.04), FIGO stage (P = 0.006, P = 0.006), and lymph node involvement (P = 0.003, P = 0.002), but not patients' age (P = 0.5, P = 0.5), histological grade (P = 0.7, P = 0.6), and histological type (P = 0.4, P = 0.6) were associated with disease-free and overall survival, respectively. The GPS was associated with FIGO stage (P < 0.001) and histological grade (P = 0.02). The GPS can be used as an inflammation-based predictor for survival in patients with cervical cancer.
    International Journal of Gynecological Cancer 08/2010; 20(6):1052-7. · 1.94 Impact Factor
  • Geburtshilfe und Frauenheilkunde 05/2010; 70(05). · 0.85 Impact Factor

Publication Stats

2k Citations
758.54 Total Impact Points

Institutions

  • 2011–2013
    • Karl Landsteiner Institut
      Wien, Vienna, Austria
  • 2012
    • Ruhr-Universität Bochum
      Bochum, North Rhine-Westphalia, Germany
  • 1998–2012
    • Medical University of Vienna
      • Universitätsklinik für Frauenheilkunde
      Vienna, Vienna, Austria
  • 2006
    • Duke University
      Durham, North Carolina, United States
  • 2005
    • Universitätsklinikum Freiburg
      • Department of Obstetrics and Gynaecology
      Freiburg, Lower Saxony, Germany
    • Medizinische Universität Innsbruck
      • Univ.-Klinik für Gynäkologie und Geburtshilfe
      Innsbruck, Tyrol, Austria
  • 1998–2005
    • University of Vienna
      • Department of Gynecology
      Wien, Vienna, Austria
  • 2004
    • University of Freiburg
      Freiburg, Baden-Württemberg, Germany
    • Johannes Gutenberg-Universität Mainz
      Mayence, Rheinland-Pfalz, Germany
  • 2003
    • Landesklinikum Sankt Pölten
      Sankt Pölton, Lower Austria, Austria
  • 2001–2003
    • Martin Luther University of Halle-Wittenberg
      • Department of Geoecology
      Halle, Saxony-Anhalt, Germany
  • 2000–2002
    • Baylor College of Medicine
      • Department of Obstetrics and Gynecology
      Houston, TX, United States
  • 1999
    • Medical University of Graz
      Gratz, Styria, Austria