Andreas Du Bois

• Kliniken Essen-Mitte Knappschafts-Krankenhaus

Background Anastomotic leakage is a significant complication following bowel resection in cytoreductive surgery for ovarian cancer. Previous studies have highlighted the detrimental effects of anastomotic leakage on patients’ postoperative course. However, there is still a lack of precise identification of the high-risk population and established s...

Objectives The German quality assurance program (QS-Ovar) representatively documents treatment and survival for patients with first diagnosis of primary ovarian cancer in the third quarters of 2004, 2008, 2012, 2016, and 2021. We evaluate lymphadenectomy (LNE) rates in dependence on histologic subtype and outcome for early ovarian cancer FIGO I. Me...

Zielsetzung: QS-Ovar dokumentierte 2004/2008/2012/2016 und 2021 alle Ovarialkarzinomerstdiagnosen (OC) im 3. Quartal. Diese repräsentative Datenerhebung evaluiert Therapiestandardumsetzung und Outcome für FIGO I Ovarialkarzinome. Materialien/Methoden: Die Therapiequalität orientierte sich an gültigen Therapiestandards und Leitlinien. OP-Qualität wu...

Objective The aim of this study was to investigate the association of co-medication with metformin, a statin, or beta blocker with survival in patients with primary ovarian cancer. Methods Individual data from three phase III, randomized controlled trials (AGO-OVAR 11, AGO-OVAR 12, and AGO-OVAR 16) and one phase II trial (AGO-OVAR 15) were pooled...

Background Treatment of elderly ovarian cancer (OC) patients follows a fine line between risk and benefit and is often below recommended standards. The German quality assurance program QS Ovar provides a deep and representative insight into the treatment of elderly OC patients and their outcome during the past decade. Methods All German hospitals w...

Background Recent and detailed data regarding treatment quality of patients with AOC in the era of precision medicine are largely unknown in Germany. Methods All German hospitals treating patients with ovarian cancer were asked to document prospectively all patients with first diagnosis in the third quarter in 2021. Details of tumor, treatment and...

Objective Borderline tumors of the ovary are a rare group of ovarian neoplasms with distinctive histological features. Considering their favorable prognosis and occurrence at a younger age, fertility-sparing surgery may be considered. Several risk factors have been identified as contributing to a higher recurrence rate, while the impact of pathohis...

Highlighting over 50 hot topics where controversy exist in management of patients with gynecologic malignancy, this book presents expertly argued opinions for and against, incorporating current evidence and clinical trials outcomes. A diverse range of topics are included that pertain to several disciplines in gynecologic oncology, including surgica...

5566 Background: Anastomotic leakage (AL) is an important and severe complication following bowel resection in cytoreductive surgery (CRS) for ovarian cancer (OC). Identifying patients (pts) at risk for AL could improve clinical management and reduce frequency and severity of complications. Methods: AGO-OVAR.OP3/LION intraoperatively randomized 647...

Simple Summary The availability of multiple gene panel testing allows us to identify germline pathogenic variants of validated cancer genes. We evaluated the prevalence and clinical/prognostic impact of deleterious germline mutations in OC patients. Germline panel testing should be performed for all patients with ovarian cancer. Better prognosis wa...

Objective The quality assurance program for ovarian cancer (QS-OVAR) evaluates the implementation of treatment standards and impact on survival for International Federation of Gynecology and Obstetrics (FIGO) stage I ovarian cancer. Methods Patients with a first diagnosis of ovarian cancer, diagnosed in the third quarter of 2004, 2008, 2012, and 2...

Background Sex cord–stromal tumors (SCST) and malignant ovarian germ cell tumors (MOGCT) are rare ovarian neoplasms that disproportionally affect young women. As prognosis is excellent throughout all stages, quality of life issues are important topics for long-term survivors.AimsTo investigate the prevalence of fertility-preserving therapy in patie...

Objective: Adult granulosa cell tumors represent less than 5% of all ovarian malignancies. The aim of this study was to analyze the clinicopathological parameters and their impact on progression-free and overall survival. Methods: Patients with primary adult granulosa cell tumors treated in three international referral centers between July 1999...

Purpose: The PAOLA-1/ENGOT-ov25 trial of maintenance olaparib plus bevacizumab for newly diagnosed advanced high-grade ovarian cancer demonstrated a significant progression-free survival (PFS) benefit over placebo plus bevacizumab, particularly in patients with homologous recombination deficiency (HRD)-positive tumors. We explored whether mutation...

Introduction/Background: Recent data regarding treatment quality and outcome of patients with early Ovarian Cancer (FIGO I) on a nationwide basis are largely missing for Germany. Methodology: All German hospitals treating patients with ovarian cancer were asked to document all patients with first diagnosis in the third quarter of the years 2004, 20...

Introduction/Background Outcome of patients with AOC depends largely on treatment quality and expertise of treating physicians and centers. To assess treatment reality and quality in Germany, we initiated a nationwide quality assurance program. Methodology All German hospitals treating patients with AOC were asked to document their patients with p...

Introduction/Background The aim of the study was to assess the oncological outcomes of cytoreductive surgery in FIGO IV and recurrent endometrial cancer. Methodology This is a retrospective, observational, single-center cohort study including patients with endometrial cancer FIGO IV stage disease undergoing primary cytoreductive surgery and recurr...

Introduction/Background The time window prior to debulking surgery offers a unique opportunity to directly study the response of treatment-naïve epithelial ovarian cancer (EOC) to targeted therapies alone or in combinations and to obtain serial tissue and liquid biopsies to study clinically useful predictive biomarkers, e.g. for poly-ADP-ribose-pol...

Introduction/Background The diagnostic evaluation of HRD is central to define targeted therapy strategies for patients with ovarian carcinoma, so advances in decentralized genomic profiling are mandatory to allow for broader testing. We show the feasibility of implementing HRD assays in academic setting laboratories, and evaluate prevalence of geno...

Introduction/Background Many gynecologic cancers fulfill the criteria of a rare tumor with an annual incidence of <6 per 100,000 women. As these tumor entities are difficult to treat, specialized knowledge and skills are necessary. We analyzed the 11-year experience with rare tumors in a tertiary gynecologic oncology center. Methodology All consec...

Introduction/Background The identification of a robust immunohistochemical marker to predict the response to bevacizumab in ovarian cancer is of high clinical interest. VEGF-A, the molecular target of bevacizumab, is expressed as multiple isoforms with pro- or anti-angiogenic properties, of which VEGF-A165b is the most dominant anti-angiogenic isof...

Introduction/Background Borderline ovarian tumors (BOT) are considered rare tumors of the ovary and often occur in young patients, which is why fertility-sparing surgery (FSS) is of great importance. Methodology Patients treated with a BOT between 1999 and 2022 in our gynecologic oncology center were included in this analysis. In all cases, an ext...

Introduction/Background To assess the disease-free survival (DFS) of patients with low-grade endometrioid ovarian cancer apparently confined to the ovary, according to surgical staging. Secondary endpoint was to evaluate the DFS according to adjuvant chemotherapy. Methodology Multicenter, retrospective, observational cohort study. Patients with en...

Introduction/Background The DESKTOP III trial has demonstrated a significant survival benefit in AGO-score positive patients who underwent complete cytoreduction at 1st relapse compared to those treated with chemotherapy alone. The question whether eligible patients who missed the opportunity of potentially life prolonging surgery at 1st relapse wo...

Introduction/Background Maintenance or improvement of health-related quality of life (QoL) is a major goal for patients with advanced ovarian cancer (OC). QoL is influenced by symptoms on the one and effects of surgical and systemic treatment on the other side. In addition, QoL is also an important patient centered endpoint in trials to support end...

Einleitung Deutschlandweite Daten zur Therapiequalität und zum Krankheitsverlauf von Patientinnen mit Rezidiv eines Ovarialkarzinoms gibt es bisher nicht. Methodik Alle Krankenhäuser in Deutschland, die Patientinnen mit Ovarialkarzinom behandeln, wurden angeschrieben, bei Patientinnen mit Erstdiagnose im dritten Quartal 2012 und 2016 Tumordaten, T...

Zielsetzung QS-Ovar dokumentierte von 2004 bis 2016 alle im 3. Quartal erstdiagnostizierten Ovarialkarzinome (OC). Diese repräsentative Datenerhebung soll Umsetzung von Therapiestandards und Auswirkungen auf das Überleben für FIGO I Ovarialkarzinome evaluieren. Methoden Die Therapiequalität orientierte sich an gültigen Therapiestandards und Leitli...

Introduction The intention of this study was to evaluate the level of anxiety and depression of malignant ovarian germ cell (MOGCT) and sex cord stromal tumors (SCST) survivors and to identify possible alterable cofactors. Methods CORSETT was an observational, multicenter, mixed retrospective/prospective cohort study of the AGO Studygroup. Women w...

Objective This international study aimed to investigate the impact of substage, histological type and other prognostic factors on long-term survival for stage I ovarian carcinoma. Methods Our study was a retrospective multicenter cohort study that included patients with the International Federation of Gynecology and Obstetrics (FIGO) stage I (IA-I...

Background Recent and detailed data regarding treatment quality and outcome of patients with relapsed OC on a nationwide basis are largely unknown in Germany. Methods All German hospitals treating patients with ovarian cancer were asked to document all patients with first diagnosis in the third quarter in 2012 and in 2016. Details of tumor, treatme...

The diagnostic evaluation of homologous recombination deficiency (HRD) is central to define targeted therapy strategies for patients with ovarian carcinoma. In this project, we evaluated HRD in 514 ovarian carcinoma samples by next-generation sequencing of DNA libraries including biotinylated probes covering BRCA1/BRCA2 and 26,523 SNPs using the st...

Purpose The identification of a robust IHC marker to predict the response to antiangiogenic bevacizumab in ovarian cancer is of high clinical interest. VEGF-A, the molecular target of bevacizumab, is expressed as multiple isoforms with pro- or antiangiogenic properties, of which VEGF-A165b is the most dominant antiangiogenic isoform. The balance of...

The Gynecologic Cancer InterGroup (GCIG) sixth Ovarian Cancer Conference on Clinical Research was held virtually in October, 2021, following published consensus guidelines. The goal of the consensus meeting was to achieve harmonisation on the design elements of upcoming trials in ovarian cancer, to select important questions for future study, and t...

Objectives: Therapy for early-stage epithelial ovarian cancer (EOC) involves complete surgical staging with or without adjuvant chemotherapy. The current international multi-center study aimed to investigate the long-term survival of different histological subtypes for stage I EOC. Methods: A multi-center cohort study was performed among all patien...

Objectives: Bowel dysfunction is frequently reported in patients with gynecologic cancers and could be validly estimated after large bowel resection by low anterior resection syndrome (LARS) scoring. We aimed to evaluate the prevalence of LARS-like symptoms in primary diagnosed ovarian cancer (OC) and the effect of surgery regarding recto-sigmoid r...

5556 Background: Standard treatment for advanced ovarian cancer (aOC) includes primary cytoreductive surgery followed by chemotherapy (PDS > CTX). There is strong evidence that this strategy is accompanied by high risk for early failure in some patients (pts) but prospective multicenter data for this specific question are lacking. Methods: 64 AGO-s...

e17613 Background: Outcome of patients with ovarian cancer depends largely on treatment quality and expertise of treating physicians and centers. To assess treatment reality and quality in Germany, we initiated a nationwide quality assurance program. Methods: All German hospitals treating patients with ovarian cancer were asked to document their pa...

e17609 Background: Maintenance or improvement of health-related quality of life (QoL) is one of the major goals for patients with advanced ovarian cancer (OC). QoL is influenced by symptoms of disease on the one and beneficial or adverse effects of surgical and systemic treatment on the other side. In addition, QoL is also an important patient cent...

Background High-grade serous ovarian cancer (HGSOC) is the most common subtype of ovarian cancer and is associated with high mortality rates. Surgical outcome is one of the most important prognostic factors. There are no valid biomarkers to identify which patients may benefit from a primary debulking approach. Objective Our study aimed to discover...

5520 Background: The DESKTOP III trial has demonstrated a significant survival benefit in AGO-score positive patients who underwent complete cytoreduction at 1st relapse compared to those treated with chemotherapy alone. The question whether eligible patients who missed the opportunity of potentially life prolonging surgery at 1st relapse would ben...

Background A high percentage of epithelial ovarian cancers (EOC) express the estrogen receptor (ER), which is an ideal target for endocrine therapy. Letrozole is a proven, potent aromatase inhibitor, extensively tested and used in the treatment of ER positive breast cancer. In addition, it seems a potent drug for patients with heavily pre-treated O...

Introduction Hereditary factor (F) XIII-deficiency is a known risk factor for postoperative complications, but data of acquired FXIII-deficiency in malignancies are limited. Therefore, we evaluated the role of acquired FXIII-deficiency in surgery for advanced epithelial ovarian cancer (EOC). Materials and methods We performed a retrospective analy...

Objective The international Charité-MAYO Conference aims to promote international dialog on diagnostics, management, scientific breakthroughs, and state-of-the-art surgical procedures in gynecology and gynecologic oncology and senology. Live surgeries are a fundamental tool of interdisciplinary and international exchange of experts in their respect...

Tubo-ovarian high-grade serous carcinomas (HGSC) are highly proliferative neoplasms that generally respond well to platinum/taxane chemotherapy. We recently identified minichromosome maintenance complex component 3 (MCM3), which is involved in the initiation of DNA replication and proliferation, as a favorable prognostic marker in HGSC. Our objecti...

(Abstracted from N Engl J Med 2021;385:2123–2131) Standard of care treatment for advanced ovarian cancer involves primary macroscopic resection of all tumor followed by platinum-based combination chemotherapy with or without additional systemic therapy including bevacizumab or a poly(adenosine diphosphate-ribose) polymerase (PARP) inhibitor. The De...

Background In ovarian carcinomas, the likelihood of disease cure following first-line medical-surgical treatment has been poorly addressed. The objective was to: (a) assess the likelihood of long-term disease-free (LDF) > 5 years; and (b) evaluate the impact of the tumour primary chemosensitivity (assessed with the modelled CA-125 KELIM) with respe...

Background: Following disappointing results with PD-1/PD-L1 inhibitors in ovarian cancer, it is essential to explore other immune targets. The aim of this study is to describe the tumor immune microenvironment (TME) according to genomic instability in high grade serous ovarian carcinoma (HGSOC) patients receiving primary debulking surgery followed...

Background The present prospective study aimed at determining the impact of cell-free tumor DNA (ct-DNA), CA125 and HE4 from blood and ascites for quantification of tumor burden in patients with advanced high-grade serous epithelial ovarian cancer (EOC). Methods Genomic DNA was extracted from tumor FFPE and ct-DNA from plasma before surgery and on...

Polygenic risk scores (PRS) for epithelial ovarian cancer (EOC) have the potential to improve risk stratification. Joint estimation of Single Nucleotide Polymorphism (SNP) effects in models could improve predictive performance over standard approaches of PRS construction. Here, we implemented computationally efficient, penalized, logistic regressio...

Polygenic risk scores (PRS) for epithelial ovarian cancer (EOC) have the potential to improve risk stratification. Joint estimation of Single Nucleotide Polymorphism (SNP) effects in models could improve predictive performance over standard approaches of PRS construction. Here, we implemented computationally efficient, penalized, logistic regressio...

Background: Chromosomal instability, a hallmark of cancer, results in changes in the copy number state. These deviant copy number states can be detected in the cell-free DNA (cfDNA) and provide a quantitative measure of the ctDNA levels by converting cfDNA next-generation sequencing results into a genome-wide copy number instability score (CNI-Sco...

Background Predictive models based on radiomics features are novel, highly promising approaches for gynaecological oncology. Here, we wish to assess the prognostic value of the newly discovered Radiomic Prognostic Vector (RPV) in an independent cohort of high-grade serous ovarian cancer (HGSOC) patients, treated within a Centre of Excellence, thus...

ARID1A (BAF250a) is a component of the SWI/SNF chromatin modifying complex, plays an important tumour suppressor role, and is considered prognostic in several malignancies. However, in ovarian carcinomas there are contradictory reports on its relationship to outcome, immune response, and correlation with clinicopathological features. We assembled a...

Background Treatment for patients with recurrent ovarian cancer has been mainly based on systemic therapy. The role of secondary cytoreductive surgery is unclear. Methods Download a PDF of the Research Summary. We randomly assigned patients with recurrent ovarian cancer who had a first relapse after a platinum-free interval (an interval during whi...

Purpose Malignant ovarian germ cell (MOGCT) and sex cord stromal tumors (SCST) are ovarian neoplasms that affect disproportionally young women. Little is known about the impact of surgical and adjuvant management of these patient’s sexual life. This study investigated the effect of fertility-sparing surgery on sexual activity and global quality of...

Purpose The chemotherapy response score (CRS) is a histopathological tool to evaluate response to neoadjuvant chemotherapy (NACT) in high-grade serous ovarian cancer (OC). We critically evaluated the clinical value of CRS and compared its predictive power to standard serological (CA125) and radiological response. Methods A retrospective analysis o...

PurposeCurrent guidelines for Lynch syndrome detection in endometrial cancer (EC) patients rely either on risk evaluation, based on personal/family history, or detection of mismatch repair (MMR) deficiency on tumor tissue. We present a combined screening algorithm for Lynch syndrome.Methods In this study, 213 consecutive patients treated for EC at...

Introduction/Background* Adult granulosa cell tumors (aGCT) represent less than 5% of all ovarian malignancies. The aim of this study was to analyze clinical and histopathological parameters and their impact on recurrence, progression-free- (PFS) and overall survival (OS). Methodology Patients diagnosed with primary aGCT and treated in three inter...

Introduction/Background* Radiation field planning in patients with locally advanced cervical cancer (LACC) undergoing primary definitive chemoradiotherapy is influenced by lymph node (LN) status. LN assessment by imaging methods has several known limitations including a high false negative rate. The present study aimed to compare the accuracy of LN...

Introduction/Background* The international Charité MAYO Conference aims at promoting international dialogue on diagnostics, management, scientific breakthroughs and state-of-the-art surgical procedures in gynecology and gynecological oncology. Live surgeries are a fundamental tool of interdisciplinary and international exchange of experts in their...

Introduction/Background* Recent and detailed data regarding treatment quality and outcome of patients with high grade AOC on a nationwide basis are largely unknown in Germany. Methodology All German hospitals treating patients with ovarian cancer were asked to document all patients with first diagnosis in the third quarter in 2012 and 2016. Detail...

Introduction/Background* Debulking surgery is the mainstay of treatment for patients (pts) with advanced epithelial ovarian cancer (EOC). Upfront surgery (PDS) with complete macroscopic resection (TR0) is associated with best survival while PDS to small residual disease (TR1-10) provides moderate benefit in high grade serous OC. The impact of resec...

Introduction/Background* The detection of gBRCA1/2 mutations in patients (pts) with epithelial ovarian cancer (EOC) provides information regarding family risk and influences clinical management, e.g. use of PARP inhibitors. The availability of next generation sequencing (NGS) allows for simultaneous sequencing of multiple cancer risk genes includin...

Introduction/Background* There is poor evidence from mostly retrospective series whether co-medication with metformin, statin or beta-blocker have an impact on survival in patients with primary ovarian cancer. The aim of this study was to investigate the association of these medications with survival. Methodology Individual data from 3 prospective...

Purpose Previously, we developed breast cancer BRCA1-like and BRCA2-like copy-number profile shrunken centroid classifiers predictive for mutation status and response to therapy, targeting homologous recombination deficiency (HRD). Therefore, we investigated BRCA1- and BRCA2-like classification in ovarian cancer, aiming to acquire classifiers with...

ARID1A (BAF250a) is a component of the SWI/SNF chromatin modifying complex, plays an important tumor suppressor role, and is considered prognostic in several malignancies. However, in ovarian carcinomas there are contradictory reports on its relationship to outcome, immune response, and correlation with clinicopathological features. We assembled a...

Background: We evaluated the clinical impact of germline (g)BRCA1/2-mutation on initial disease presentation, surgical implications, surgical morbidity and survival in patients with advanced epithelial ovarian cancer (EOC) undergoing debulking surgery (DS). Methods: Data of all consecutive EOC patients with stage III/IV, high-grade serous diseas...

Objectives In the Phase III PAOLA-1/ENGOT-ov25 (NCT02477644) trial, the addition of the PARP inhibitor olaparib to bevacizumab maintenance therapy led to a significant progression-free survival (PFS) benefit in patients with newly diagnosed advanced ovarian cancer (hazard ratio [HR] 0.59; 95% confidence interval [CI] 0.49-0.72), particularly in pat...

Background Many loci have been found to be associated with risk of epithelial ovarian cancer (EOC). However, although there is considerable variation in progression-free survival (PFS), no loci have been found to be associated with outcome at genome-wide levels of significance. Methods We carried out a genome-wide association study (GWAS) of PFS i...