B Rau

HELIOS Klinikum Berlin-Buch, Berlín, Berlin, Germany

Are you B Rau?

Claim your profile

Publications (116)300.98 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Background: Surgical site infections (SSI) are among the most frequent healthcare-associated infections. They impose a substantial burden with increased morbidity and exceeding healthcare costs. Risk factors such as age, diabetes, and smoking status are commonly accounted for in the literature, but few studies address gender differences. Methods: Data from the German Nosocomial Infections Surveillance System (Krankenhaus-Infektions-Surveillance-System (KISS)) from 2005 to 2010 were analysed for cardiac, vascular, visceral, and orthopaedic surgery, with a total of 438,050 surgical pro- cedures and 8,639 SSI. Rates of SSI and isolated pathogens were analysed for gender. Results: Women had a lower rate of SSI (SSI/100 procedures) in abdominal surgery than men (2.92 vs. 4.37; p < 0.001). No gender-specific differences were found in orthopaedic and vascular surgery, while women had a higher risk for SSI in cardiac surgery (5.50 vs. 3.02; p < 0.001). Isolated pathogens showed differences for sensitive Staphylococcus aureus and Pseudomonas aeruginosa, which were more frequent in women (both p = 0.007), while coagu- lase-negative staphylococci occurred more often in men (18.8 vs. 14.0%; p < 0.001). Conclusion: Gender differences in SSI exist and are procedure-specific. The underlying mechanisms need to be further elucidated so that targeted measures for the prevention of SSI can be developed.
    Viszeralmedizin / Visceral Medicine 01/2014; 30:4-4. · 0.07 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: OBJECTIVE: To investigate the course of health-related quality of life (HQL) over time in patients with peritoneal carcinomatosis (PC) after complete cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC). METHODS: Prospective, single-center, nonrandomized cohort study using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire. RESULTS: Ninety patients who underwent CRS and HIPEC for PC in our institution were enrolled in the study. Mean age was 56 years (range 27-77 years) (61 % female). Primary tumor was colorectal in 21 %, ovarian in 19 %, pseudomyxoma peritonei in 16 %, an appendix tumor in 16 %, gastric cancer in 10 %, and peritoneal mesothelioma in 13 % of cases. Mean peritoneal carcinomatosis index was 22 (range 2-39). Mean global health status score was 69 ± 25 preoperatively and 55 ± 20, 66 ± 22, 66 ± 23, 71 ± 23, and 78 ± 21 at months 1, 6, 12, 24, and 36, respectively. Physical and role function recovered significantly at 6 months and were close to baseline at the 24-month measurement. Emotional function starting from a low baseline recovered to baseline by month 12. Cognitive and social function had slow recovery on follow-up. Fatigue, diarrhea, dyspnea, and sleep disturbance were symptoms persistent at 6-month follow-up, improving later on in survivors. CONCLUSIONS: Survivors after CRS and HIPEC have postoperative quality of life similar to preoperatively, with most of the reduced elements recovering after 6-12 months. We conclude that reduced quality of life of patients after CRS and HIPEC should not be used as an argument to deny surgical therapy to these patients.
    Annals of Surgical Oncology 08/2012; · 4.12 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Cytoreductive surgery (CRS) followed by hyperthermic intraperitoneal chemotherapy (HIPEC) can improve the prognosis of selected patients with peritoneal surface malignancy (PSM). Usually, treatment is performed as an extensive one-step approach. We investigated the feasibility of delayed HIPEC, if the one-step procedure was interrupted precociously. 42 patients with PSM who underwent CRS and delayed HIPEC from 2006-2008 were studied. HIPEC was performed 5 days after treatment with mitomycin, cisplatin and hyperthermia. Perioperative complications and toxicity were analyzed. Delayed HIPEC was successfully completed in 40 of the 42 patients. In 2 cases, HIPEC was omitted because of complications during chemotherapy (anastomotic leakage and retroperitoneal edema). Minor and major surgical complications occurred in 18 and 9 of the 40 patients treated with HIPEC (45 vs. 22.5%), respectively. Toxicity grade II-IV (WHO criteria) was observed in 4 of them (10%). Median stay in the intensive care unit was 9 days (range 2-31) while the mean hospitalization time was 24 days (range 14-59). In this series, there was no mortality. Postponement of HIPEC after CRS (two-step approach) is feasible. Analysis of morbidity and mortality showed no significant difference to the one-step approach reported in the literature and no disadvantages for the patient. The two-step approach is an alternative option for patients who had to discontinue the one-step approach due to unpredictable intraoperative complications.
    European Surgical Research 01/2011; 47(1):19-25. · 0.75 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Peritoneal carcinomatosis represents a clinical condition with a limited perspective concerning long term survival. The combination of surgical cytoreduction and hyperthermic intraperitoneal chemotherapy (HIPEC) represents a complex multimodal therapeutic management concept with promising results for prolongation of survival. For the identification of pitfalls during implementation of the HIPEC procedure into clinical practice an observational study was conducted. Between 2005 and 2009 data from all patients treated with cytoreductive surgery and HIPEC for peritoneal carcinomatosis was prospectively collected and analysed. During the observational interval a total of 42 patients underwent surgical treatment for peritoneal carcinomatosis. In 34 patients the complete procedure with surgical cytoreduction and HIPEC was performed. Perioperative mortality (6%) and morbidity (35%) was similar to other reported series. Twenty-five patients (76%) survived the 18 months follow-up period after complete procedure. The multimodal therapeutic treatment concept of surgical cytoreduction and following HIPEC leads to promising results for patients suffering from peritoneal carcinomatosis. However this treatment concept is afflicted with a relevant risk of postoperative complications.
    Acta chirurgica Belgica 01/2011; 111(2):68-72. · 0.36 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (HIPEC) offers patients with peritoneal cancer of various origins the chance of a relevant increase in life expectancy. These cases are very complex from a medical viewpoint and very expensive from an economical aspect. An analysis of case cost calculations was performed to find out whether this procedure can on average be carried out cost-effectively by a maximum care university. All cases from 2008 in which HIPEC was carried out were analyzed. The types of main diagnosis, secondary diagnoses, procedures, times from incision to suture and hospital stay were analyzed. On the basis of the case costs the proceeds and marginal returns were calculated from the diagnosis-related groups (DRGs) and additional remuneration when applicable. The causes of positive and negative marginal returns were explained using the InEK cost matrix. In 18 patients there were 9 different main diagnoses and 7 different "main procedures" (from a surgical perspective the most resource intensive procedures) and a total of 10 different DRGs were identified in the grouping algorithm. With an average of 2 operations (range 1-7) per patient the summed incision-to-suture time was 423 min (170-962 min). The patients stayed on average 6.4 days (1.3-17.6 days) in intensive care. The average case cost was 21,072€ (range 8,657-55,904€) and the proceeds 20,474€ (6,333-37,497€). Each case had on average a debit balance of 598€ (range from 11,843€ profit balance to 18,407€ debit balance) with an assumed base rate of 2,786€. The causes for positive or negative marginal profits were mostly operating times, incision-to-suture times and duration of intensive care. The proceeds showed on average a deficit of only 3% compared to the costs. The operating times must be decreased by optimization particularly of the preoperative approach. Interventions should be carried out in one stage only and the intraoperative connecting and waiting times should be reduced in order to reduce the incision-to-suture times.
    Der Chirurg 11/2010; 81(11):1005-12. · 0.52 Impact Factor
  • British Journal of Surgery 01/2010; 97(2):294-295. · 4.84 Impact Factor
  • Allgemein- und Viszeralchirurgie up2date 01/2010; 4(04):205-223.
  • [Show abstract] [Hide abstract]
    ABSTRACT: Überwärmungstherapie (Hyperthermie) von Tumoren auf 40–44°C kann nicht nur die Wirksamkeit von Radiotherapie und/oder Chemotherapie verstärken, sondern hat noch weitere physiologische, immunstimulierende und molekularbiologische Effekte. Es wurden kommerzielle Therapiesysteme für die lokale, interstitielle, regionale und systemische (Ganzkörper-) Hyperthermie entwickelt und klinisch eingesetzt. In Phase-III-Studien konnte eine Erhöhung der lokalen Kontrolle bei malignen Melanomen (Rezidiven), Mammakarzinomen (Rezidiven) und Kopf-Hals-Karzinomen (Lymphknotenmetastasen) gezeigt werden, bei Glioblastomen und Zervixkarzinomen sogar ein verbessertes Überleben. In präoperativen Konzepten ist die Hyperthermie interessant, da sie weder die akute noch die perioperative Toxizität erhöht. Für eine routinemäßige Anwendung muss die Gerätetechnik weiterentwickelt werden, um Dosierbarkeit, Effektivität, Praktikabilität und Kosten/Nutzen-Relation zu verbessern und den Indikationsbereich zu erweitern.
    12/2009: pages 319-332;
  • [Show abstract] [Hide abstract]
    ABSTRACT: Oesophageal anastomotic leakage is associated with considerable morbidity and mortality. The aim of the present study was to assess the feasibility of using temporary self-expanding plastic stents to treat postoperative oesophageal leaks. Patients with anastomotic leakage after abdominothoracic oesophagectomy treated by endoscopic insertion of self-expanding plastic stents between 2001 and 2007 were studied. Clinical outcomes were analysed, including healing of the leak, morbidity and mortality. Stents were inserted successfully in all 22 patients without procedure-related complications. Ten patients also required computed tomography-guided drainage because surgical drains had been removed. Non-ventilated patients received oral nutrition a mean of 4 days after stent placement. Combined treatment with stenting and drainage resulted in resolution of the leak in 21 of 22 patients. The mean healing time (time to stent removal) was 23 days. Stent migration occurred in five of 22 patients, but endoscopic reintervention with placement of a new stent was successful in all patients. Repeat thoracotomy with intraoperative stent placement was necessary in one patient with an oesophagocolonic anastomosis. One patient died in hospital. In combination with effective drainage, self-expanding plastic stents are an option for the treatment of oesophageal anastomotic leaks, and may reduce leak-related morbidity and mortality.
    British Journal of Surgery 09/2009; 96(8):887-91. · 4.84 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Bei der Thermotherapie mit magnetischen Nanopartikeln, oder auch kurz Nanotherapie, handelt es sich um ein neues Therapiekonzept, bei dem Tumorzellen durch lokal in den Tumor eingebrachte Wärme geschädigt werden. Das Prinzip dieser Methode ist die direkte Applikation einer magnetischen Flüssigkeit in den Tumor und ihre anschließende Erwärmung in einem magnetischen Wechselfeld. In Abhängigkeit von Temperatur und Einwirkdauer führt die Behandlung entweder zu einer direkten Schädigung der Tumorzellen oder macht diese empfindlicher gegenüber einer begleitenden Radio- oder Chemotherapie. Die Ergebnisse von 3 Machbarkeitsstudien (Phase I) zur Behandlung des Glioblastoms, des Prostata- sowie des Ösophaguskarzinoms werden vorgestellt. Thermotherapy using magnetic nanoparticles, also termed nanotherapy, is a new therapeutic concept. Tumor cells are damaged by local application of heat. This method comprises direct injection of a magnetic fluid into the tumor and its subsequent heating in an alternating magnetic field. Depending on the applied temperature and the duration of heating, the therapy either results in direct death of tumor cells or makes the cells more susceptible to concomitant radiotherapy or chemotherapy. The results of three feasibility studies for the treatment of glioblastoma, prostate cancer, and esophageal cancer are presented.
    Der Onkologe 09/2007; 13(10):894-902. · 0.13 Impact Factor
  • Onkologe. 01/2007; 13(10):894-902.
  • [Show abstract] [Hide abstract]
    ABSTRACT: Die Rate an betagten Patienten über 75 Jahre – und damit auch die Inzidenz des kolorektalen Karzinoms – nimmt in Europa weiter zu. Ebenfalls steigend ist die durchschnittliche Lebenserwartung. Für Patienten bis 75 Jahre wurden Therapiestandards etabliert. Gilt dies auch für betagte Patienten? In diesem Artikel wird die Problematik der Entscheidungskaskade bei älteren Patienten mit einem kolorektalen Karzinom dargestellt. Es soll gezeigt werden, dass bei risikoadaptierter Operations- und Behandlungsindikation ältere Patienten mit einem kolorektalen Karzinom eine vertretbare Morbidität gegenüber jüngeren Patienten und eine vergleichbare onkologische Prognose haben.
    Der Onkologe 01/2007; 13(9). · 0.13 Impact Factor
  • Onkologe. 01/2007; 13(9):813-822.
  • [Show abstract] [Hide abstract]
    ABSTRACT: Die häufigsten kardiopulmonalen Erkrankungen alter Menschen, die gerade in der präoperativen Phase erkannt und ggf. hinsichtlich der Therapie optimiert werden müssen, sind COPD, Asthma bronchiale, stumme Aspirationen, koronare Herzerkrankung, Herzinsuffizienz, absolute Arrhythmie, Herzklappenfehler und arterielle Hypertonie. Gelegentlich sind diese Krankheiten primär nicht diagnostiziert worden. Deshalb wird für die präoperative Diagnostik neben einer subtilen Anamneseerhebung und klinischen Untersuchung auch eine weitere apparative Basisdiagnostik empfohlen. Diese umfasst Ruhe-EKG, Röntgen-Thorax, Spirometrie und Blutgasanalyse. Nur bei auffälligen Befunden sind weiterführende diagnostische Schritte erforderlich. In jedem Fall muss überprüft werden, ob die bereits verordnete Dauermedikation für die festgestellten Erkrankungen optimal ist. Bei V.a. schwere kardiale Erkrankungen sollten zusätzliche Untersuchungen (Echokardiographie, Ergometrie, Koronarographie) erfolgen. Neben der Optimierung der Medikation ist bei präoperativen Patienten die Konditionierung durch physiotherapeutische Behandlungen sinnvoll. The most common cardiovascular diseases are asthma, obstructive lung disease, aspirations, coronary atherosclerotic disease, heart failure, atrial fibrillation, valvular disease, and arterial hypertension. Very often, these diseases are not known in the preoperative setting. We describe the basic diagnostic procedures recommended for each patient and the specific diagnostic pathways in case the patient’s history and/or the basic procedures indicate a high risk of a specific pulmonary or cardiac disease. Usually the optimization of medical therapy is sufficient prior to surgery. Sometimes more thorough work-up is recommended (bronchoscopy, echocardiography, coronary angiography). In addition physiotherapeutic treatment is useful in almost all elderly patients.
    Der Onkologe 01/2007; 13(9):792-800. · 0.13 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: The role of postoperative adjuvant chemotherapy in patients with rectal cancer pretreated by preoperative radiochemotherapy (RCT) and curative surgery is still poorly investigated. We pooled data from both arms of a phase III trial in which patients with locally advanced (T3/4) rectal cancer were randomized to preoperative RCT alone or combined with pelvic radio-frequency hyperthermia. After surgery, R0-resected patients were scheduled to adjuvant chemotherapy with four monthly courses of 50 mg folinic acid (FA) and gradually escalated 5-fluorouracil (5-FU, 350-500 mg/m2, days 1-5). Reasons preventing initiation of chemotherapy and treatment-related toxicities were evaluated. Patients' characteristics and survival parameters were compared between the treated and untreated patient groups. Out of 93 patients, 73 (79%) started adjuvant chemotherapy, whereas 19 (21%) did not, mostly due to perioperative complications and refusal. Chemotherapy-related toxicities were mild to moderate in most cases, but--together with protracted postoperative complications--prevented the intended dose escalation of 5-FU in 71% of patients. Distant-failure-free (p=0.03) and overall survival (p=0.03) were improved in the chemotherapy group, although there was a negative selection of patients with unfavourable characteristics into the untreated patient group. Adjuvant chemotherapy using FA and 5-FU can be safely applied to the majority of patients with rectal cancer pretreated by RCT and surgery. Survival data are not suitable to allow far-reaching conclusions, but are in line with suggestions of a favourable effect of adjuvant chemotherapy in these patients.
    International Journal of Colorectal Disease 10/2006; 21(6):582-9. · 2.24 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: For the treatment of peritonitis or abdominal compartment syndrome, an open abdomen can be required. Because of the high complication rate associated with this method, different technical modifications were developed that are now being applied. Abdominal vacuum-assisted closure is increasingly favoured. We analyse our experience with this device in a distinct group of patients from gastrointestinal cancer surgery. From June 2003 to December 2005, 36 patients were treated with 151 double-layer abdominal vacuum devices. Indications for applying this device were peritonitis (n = 22), abdominal compartment syndrome (n = 11), and necrotising fasciitis (n = 3). Thirty-four patients gave anamneses of malignoma. Overall, the vacuum therapy treatment lasted a median of 13 days (range 3-48). With it, four enteric fistulas (11%) and four abdominal wall bleedings (11%) occurred. In our patient group, no new intra-abdominal abscesses were observed. Four patients died during treatment with the vacuum-assisted device and four afterward because of multiple organ failure in acute sepsis (in-hospital mortality 22%). Twenty-six patients (72%) underwent direct fascial closure after a median treatment duration of 10 days. Six patients (17%) required synthetic mesh for fascial closure. After a median follow-up of 100 days, two patients developed ventral hernias and two others showed ossification of the scar. Compared with other methods of temporary abdominal closure, our experience with the vacuum-assisted device demonstrates its advantages concerning clinical feasibility and the relatively low complication rate. The high rate of direct fascial closure with an acceptable rate of ventral hernias following vacuum-assisted abdominal closure are further benefits of this technique.
    Der Chirurg 08/2006; 77(7):586, 588-93. · 0.52 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: The present study compares quality of life (QoL) after neoadjuvant radiochemotherapy with or without hyperthermia in patients with advanced rectal cancer. Between April 1994 and May 1999, 137 patients were treated by neoadjuvant radiochemotherapy with (69 patients (50.4%)) or without (68 patients (49.6%)) hyperthermia. Forty-six patients (33.6%) filled-out a 'Gastrointestinal Quality of Life Index' (GIQLI) questionnaire at four time points (before and after neoadjuvant therapy, early after surgery and after long-term follow-up) and were included in the present study. There were no statistically significant differences in the global GIQLI index between patients treated with neoadjuvant radiochemotherapy with and without hyperthermia at any time point. The longitudinal analysis of GIQLI values in both treatment groups showed specific profiles that were identical in both treatment groups. Occurrence of severe toxicity during the neoadjuvant therapy in both arms lead to a significant temporary reduction of QoL scores at TP2 without any detrimental long-term effects. Patients with sphincter preservation and patients with sphincter resection reported similar QoL scores during long-term follow-up. Neoadjuvant radiochemotherapy with and without hyperthermia has similar effects on the QoL of patients with locally advanced rectal cancer. The addition of hyperthermia during the neoadjuvant therapy with the potentially associated inconveniences has no negative effects on QoL.
    International Journal of Hyperthermia 07/2006; 22(4):301-18. · 2.59 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: HintergrundDas offene Abdomen kann zur Behandlung einer Peritonitis oder eines abdominellen Kompartmentsyndroms erforderlich werden. Aufgrund hiermit nur bedingt zufrieden stellender Ergebnisse wurden verschiedene technische Modifikationen des Verfahrens entwickelt und angewendet. Neuerdings wird als temporrer Bauchdeckenverschluss der abdominelle Vakuumverband zunehmend propagiert. Die hiermit von uns bei einem viszeral-chirurgisch, onkologischen Patientengut gesammelten aktuellen Erfahrungen werden analysiert.Patienten und MethodeVon 2003–2005 wurden bei 36 Patienten insgesamt 151 abdominelle Zweischichtvakuumverbnde angelegt. Indikationen waren eine Peritonitis (n=22), ein abdominelles Kompartmentsyndrom (n=11) und eine nekrotisierende Fasziitis (n=3).ErgebnisseDie Behandlungsdauer betrug ber alle Gruppen 13Tage (3–48Tage). Es traten 4 enterische Fisteln (11%) sowie 4 Bauchdeckenblutungen (11%) auf. 4 Patienten verstarben whrend und 4 Patienten nach der abdominellen Vakuumtherapie im septischen Multiorganversagen. Ein direkter Faszienverschluss gelang bei insgesamt 26 Patienten (72%). Einen alloplastischen Faszienersatz erhielten 6 Patienten (17%). Bei 2 von 28 Patienten zeigte sich nach einem medianen Follow-up von 100 Tagen eine Narbenhernie und bei 2 weiteren Patienten ein Narbenknochen.SchlussfolgerungIm Vergleich zu anderen temporren Bauchdeckenverschlssen sprechen unsere Erfahrungen fr eine berlegenheit des abdominellen Vakuumverbandes bezglich der klinischen Handhabbarkeit sowie einer relativ niedrigen Rate an behandlungsassoziierten Frhkomplikationen. Auch der meist hiernach mgliche primre Faszienverschluss, mit einer fr die ursprnglich zugrunde liegende Erkrankungssituation akzeptablen Rate an Bauchwandhernien, sind Vorteile des Verfahrens.BackgroundFor the treatment of peritonitis or abdominal compartment syndrome, an open abdomen can be required. Because of the high complication rate associated with this method, different technical modifications were developed that are now being applied. Abdominal vacuum-assisted closure is increasingly favoured. We analyse our experience with this device in a distinct group of patients from gastrointestinal cancer surgery.Patients and methodFrom June 2003 to December 2005, 36 patients were treated with 151 double-layer abdominal vacuum devices. Indications for applying this device were peritonitis (n=22), abdominal compartment syndrome (n=11), and necrotising fasciitis (n=3). Thirty-four patients gave anamneses of malignoma.ResultsOverall, the vacuum therapy treatment lasted a median of 13days (range 3–48). With it, four enteric fistulas (11%) and four abdominal wall bleedings (11%) occurred. In our patient group, no new intra-abdominal abscesses were observed. Four patients died during treatment with the vacuum-assisted device and four afterward because of multiple organ failure in acute sepsis (in-hospital mortality 22%). Twenty-six patients (72%) underwent direct fascial closure after a median treatment duration of 10days. Six patients (17%) required synthetic mesh for fascial closure. After a median follow-up of 100 days, two patients developed ventral hernias and two others showed ossification of the scar.ConclusionCompared with other methods of temporary abdominal closure, our experience with the vacuum-assisted device demonstrates its advantages concerning clinical feasibility and the relatively low complication rate. The high rate of direct fascial closure with an acceptable rate of ventral hernias following vacuum-assisted abdominal closure are further benefits of this technique.
    Der Chirurg 06/2006; 77(7):586-593. · 0.52 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: In previous analyses we identified therapy-induced upregulation of the CDK inhibitor p21CIP/WAF-1 and consequently decreased tumor cell proliferation or loss of Bax as adverse factors for survival in rectal cancer treated with radiochemotherapy. Here, we address the individual role of p53 and its transcriptional targets, p21CIP/WAF-1 and Bax, on apoptosis induced by individual components of multimodal anticancer therapy, i.e. 5-fluorouracil (5-FU), ionising gamma-radiation (IR) and heat shock/hyperthermia. We analysed tumor samples 66 patients with rectal carcinoma treated by a neoadjuvant approach with radiochemotherapy +/- heat shock/hyperthermia for the expression and mutation of p53 and the expression of p21CIP/WAF-1 and Bax. These data were correlated with the tumor response. The functional relevance of p53, p21CIP/WAF-1 and Bax was investigated in isogeneic HCT116 cell mutants treated with 5-FU, IR and heat shock. Rectal carcinoma patients who received an optimal heat shock treatment showed a response that correlated well with Bax expression (p = 0.018). Local tumor response in the whole cohort was linked to expression of p21CIP/WAF-1 (p < 0.05), but not p53 expression or mutation. This dichotomy of p53 pathway components regulating response to therapy was confirmed in vitro. In isogeneic HCT116 cell mutants, loss of Bax but not p53 or p21CIP/WAF-1 resulted in resistance against heat shock. In contrast, loss of p21CIP/WAF-1 or, to a lesser extent, p53 sensitized predominantly for 5-FU and IR. These data establish a different impact of p53 pathway components on treatment responses. While chemotherapy and IR depend primarily on cell cycle control and p21, heat shock depends primarily on Bax. In contrast, p53 status poorly correlates with response. These analyses therefore provide a rational approach for dissecting the mode of action of single treatment modalities that may be employed to circumvent clinically relevant resistance mechanisms in rectal cancer.
    BMC Cancer 02/2006; 6:124. · 3.33 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: The aim of this study was to compare CT, MRI and FDG-PET in the prediction of outcome of neoadjuvant radiochemotherapy in patients with locally advanced primary rectal cancer. A total of 23 patients with T3/4 rectal cancer underwent a preoperative radiochemotherapy combined with regional hyperthermia. Staging was performed using four-slice CT (n=23), 1.5-T MRI (n=10), and (18)F-FDG-PET (n=23) before and 2-4 weeks after completion of neoadjuvant treatment. Response criteria were a change in T category and tumour volume for CT and MRI and a change in glucose uptake (standard uptake value) within the tumour for FDG-PET. Imaging results were compared with those of pretherapy endorectal ultrasound and histopathological findings. Histopathology showed a response to neoadjuvant therapy in 13 patients whereas 10 patients were classified as nonresponders. The mean SUV reduction in responders (60+/-14%) was significantly higher than in nonresponders (37+/-31%; P=0.030). The sensitivity and specificity of FDG-PET in identifying response was 100% (CT 54%, MRI 71%) and 60% (CT 80%, MRT 67%). Positive and negative predictive values were 77% (CT 78%, MRI 83%) and 100% (CT 57%, MRI 50%) (PET P=0.002, CT P=0.197, MRI P=0.500). These results suggest that FDG-PET is superior to CT and MRI in predicting response to preoperative multimodal treatment of locally advanced primary rectal cancer.
    European Radiology 09/2005; 15(8):1658-66. · 4.34 Impact Factor

Publication Stats

2k Citations
300.98 Total Impact Points

Institutions

  • 2002–2011
    • HELIOS Klinikum Berlin-Buch
      Berlín, Berlin, Germany
  • 1998–2011
    • Charité Universitätsmedizin Berlin
      • • Department of General, Visceral and Transplantation Surgery
      • • Department of Radiation Oncology and Radiotherapy
      Berlin, Land Berlin, Germany
  • 1998–2005
    • Hochschule für Gesundheit und Medizin
      Berlín, Berlin, Germany
  • 1995–2004
    • Humboldt-Universität zu Berlin
      • Department of Psychology
      Berlín, Berlin, Germany
  • 2003
    • Humboldt State University
      Arcata, California, United States
  • 1995–2001
    • Max-Delbrück-Centrum für Molekulare Medizin
      • Experimental and Clinical Research Center (ECRC)
      Berlín, Berlin, Germany