L Hertle

Universitätsklinikum Münster, Münster, North Rhine-Westphalia, Germany

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Publications (239)615.41 Total impact

  • O. A. Brinkmann · J. Roigas · L. Hertle
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    ABSTRACT: In den letzten 10 Jahren hat sich die Immuntherapie zur Behandlung des metastasierten Nierenzellkarzinoms zunehmend etabliert. Die Zytokine Interleukin-2 (IL-2) und Interferon α (IFN-α) haben als Einzelsubstanzen die größten Effekte für die Therapie von Patienten mit metastasiertem Nierenzellkarzinom gezeigt. Beide Stoffe sind in Deutschland für die Therapie von Patienten mit metastasiertem Nierenzellkarzinom zugelassen. Die subkutanen Applikationsformen dieser beiden oftmals kombinierten Zytokine (unspezifische Immuntherapie) haben sich in Deutschland weitgehend durchgesetzt. IL-2- und IFN-α-basierte Kombinationstherapien erreichen Ansprechraten wie aggressivere (i.v.) Immuntherapiekonzepte. Die retrospektive Analyse eigener Therapieergebnisse anhand von 66 Patienten mit 5-Jahres-Follow-up nach Beginn der Immuntherapie [Therapiebewertung nach WHO – komplette Remission (CR): n=7, partielle Remission (PR): n=11, stabile Erkrankung (SD): n=20, progrediente Erkrankung (PD): n=28] deuten daraufhin, dass die Therapiebewertung entsprechend der WHO-Kriterien gemessen an anderen Parametern wie z. B. TNM-Status, Grading, Anzahl der Organsysteme mit nachgewiesener Metastasierung die größte Bedeutung für das Überleben der Patienten mit metastasiertem Nierenzellkarzinom hat. Die Verknüpfung der zytokinbasierten Immuntherapie mit anderen Therapieformen (z. B. operative Intervention) führen zu einer differenzierten Therapie in Abhängigkeit von dem jeweiligen Tumorstatus des Patienten mit metastasiertem Nierenzellkarzinom. Spezifische Immuntherapien haben zzt. noch eher experimentellen Charakter. Es besteht für keines der dargestellten Konzepte eine Zulassung. Nur eine Standardisierung dieser Protokolle kann zukünftig die Immuntherapie der Patienten mit metastasiertem Nierenzellkarzinom bereichern. Wenngleich verschiedene Aspekte der Immuntherapie dringend eine weitergehende wissenschaftliche Untersuchung benötigen, so ist die Immuntherapie die Therapie der Wahl für Patienten mit metastasiertem Nierenzellkarzinom. Um die Wertigkeit der einzelnen therapeutischen Konzepte besser erfassen zu können, wäre es sehr wünschenswert, dass die Immuntherapie von Patienten mit metastasiertem Nierenzellkarzinom prospektiv evaluiert wird. Die Deutsche Gesellschaft für Immuntherapie (DGFIT) stellt hierfür die Plattform dar.
    No preview · Article · May 2014 · Der Urologe
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    ABSTRACT: The goal of this work was to describe the change of treatment paradigms for metastatic renal cell carcinoma (mRCC) since 2006. We retrospectively investigated all mRCC patients who were treated with targeted therapy between June 2006 and June 2012 at the University of Münster. In all, 50 of 158 (31.6 %) patients were initially treated with immunotherapy. The most often used second line treatment after immunotherapy was sorafenib (29 patients, 58.0 %). The first line treatment chosen for therapy-naïve patients was sunitinib (68 patients, 63.0 %). There was no statistically significant difference between the two groups (572 vs. 554 days, p = 0.745). A total of 77 patients had synchronous metastasis (48.8 %), 55 of whom underwent cytoreductive nephrectomy. There was a significant survival benefit in favor of surgically treated patients (510 vs. 186 days, p = 0.002). After introduction of the new agents treatment paradigms have changed substantially. Immunotherapy is used only rarely. Cytoreductive nephrectomy may continue to be regarded as standard treatment until prospective data are available.
    No preview · Article · Feb 2014 · Der Urologe
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    ABSTRACT: To evaluate the predictive value of tumor volume (TV), tumor percentage (TP), and number of tumor foci (NF) in patients with prostate cancer. The prognostic relevance of TV, TP, and NF as predictors of biochemical recurrence (BCR) following radical prostatectomy (RPE) is controversial. The cohort consisted of 758 referred subjects who underwent RPE between 2000 and 2005 at the University of Muenster. The mean time of follow-up was 62 months. TV, TP, and NF were estimated visually with the assistance of a pathologic mapping grid for embedded whole-mount RPE specimens. In addition, TV and TP were assessed in a categorized fashion by using quartiles as cutoff points. Subgroup analyses for high- and low-risk patients using univariate and multivariate Cox proportional hazard analyses for BCR were performed. TV, TP, and NF were strongly related to tumor stage, Gleason score, surgical margin status, and preoperative prostate-specific antigen (PSA). In univariate analysis, all pathologic parameters including TV, TP, and NF were predictive for BCR. In multivariate analysis, only TP, tumor stage, and PSA level were independent predictors. In subgroup analysis, TP was an independent predictor for BCR in the high-risk group but not in the low-risk group. TP, but not TV or NF, was found to be an independent predictor for BCR in patients after RPE. TP seems to be more relevant in high-risk patients (i.e., any of the following:>pT2, Gleason score>6, or PSA>20ng/ml).
    No preview · Article · Dec 2013 · Urologic Oncology
  • A. Wenke · A. Gaber · L. Hertle · N. Roeder · G. Pühse
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    ABSTRACT: Hintergrund Die korrekte und vollständige DRG-Kodierung ist wichtig für die Abbildung von Leistungen und die Verteilung von Erlösen innerhalb des G-DRG-Systems. Es stellt sich die Frage, ob eine personalkostenintensive Optimierung der Kodierung durch eine positive Beeinflussung der Erlöse refinanzierbar wäre. Material und Methoden Der statistischen Analyse liegen die stationären Behandlungsfälle der Klinik und Poliklinik für Urologie des Universitätsklinikums Münster aus dem Jahre 2009 (in der DRG-Systematik des Aufnahmejahres) zu Grunde. Alle Fälle wurden mit Hilfe eines neu entwickelten Datenverarbeitungsprogramms einer schrittweisen Simulation der unterschiedlichen Schweregrade („patient clinical complexity level“, PCCL) unterzogen. Die jeweils resultierenden Erlöse wurden sowohl unter dem Aspekt einer Steigerung als auch einer Reduktion des PCCL analysiert. Ergebnisse Im urologischen Fachgebiet führen die vollständige Kodierung von Nebendiagnosen und die damit verbundene PCCL-Steigerung der Behandlungsfälle zu einer deutlichen (fiktiven) Erlössteigerung. Wie in vielen operativen Fächern ist dabei die Erlösrelevanz eng mit den kodierten Prozeduren (Operationen- und Prozedurenschlüssel, OPS) verknüpft. Das hier vorgestellte Simulationsverfahren kann abteilungsspezifisch bei der Optimierung der Kodierung und der Ermittlung von Erlöspotenzialen eine Hilfe sein. Schlussfolgerungen Die vollständige (Nebendiagnosen-) Kodierung eines Behandlungsfalls muss in der Urologie das oberste Ziel einer jeden Falldokumentation sein, um mögliche Erlöspotenziale ausschöpfen zu können.
    No preview · Article · Jul 2012 · Der Urologe
  • A Wenke · A Gaber · L Hertle · N Roeder · G Pühse
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    ABSTRACT: Precise and complete coding of diagnoses and procedures is of value for optimizing revenues within the German diagnosis-related groups (G-DRG) system. The implementation of effective structures for coding is cost-intensive. The aim of this study was to prove whether higher costs can be refunded by complete acquisition of comorbidities and complications. Calculations were based on DRG data of the Department of Urology, University Hospital of Münster, Germany, covering all patients treated in 2009. The data were regrouped and subjected to a process of simulation (increase and decrease of patient clinical complexity levels, PCCL) with the help of recently developed software. In urology a strong dependency of quantity and quality of coding of secondary diagnoses on PCCL and subsequent profits was found. Departmental budgetary procedures can be optimized when coding is effective. The new simulation tool can be a valuable aid to improve profits available for distribution. Nevertheless, calculation of time use and financial needs by this procedure are subject to specific departmental terms and conditions. Completeness of coding of (secondary) diagnoses must be the ultimate administrative goal of patient case documentation in urology.
    No preview · Article · Jun 2012 · Der Urologe
  • O.A. Brinkmann · L. Hertle
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    ABSTRACT: Pathogenic aspects of interstitial cystitis (IC) are reviewed on the basis of the current literature applying the criteria of evidence-based medicine (EBM). Three hundred forty-six peer-reviewed publications of the past 30 years were retrieved via MEDLINE employing the key words “interstitial cystitis and pathogenesis or etiology” and classified according to EBM criteria and subject categories. The papers were then reviewed and summarized and are discussed considering the theory of acute and chronic inflammatory responses. In the literature, nearly all steps of the normal inflammatory response are considered pathogenically important in development of the IC syndrome. Applying EBM criteria, all studies fail to meet the criteria for sound statistical evaluation and to demonstrate reproducibly a reliable pathogenic factor. Most publications report only small numbers of patients. Control groups are frequently lacking or too small. Clinically useful criteria for the diagnosis of IC are not properly defined. There is no commonly accepted animal model in which IC occurs naturally or can be artificially induced. Of the 683 IC papers studied, 346 (50.7%) deal with pathogenic or etiological aspects of IC. The inflationary use of the terms pathogenesis or etiology in one out of every two papers calls for more prudent application of terminology in the future. As yet, none of the published pathogenic factors was found to represent the main trigger of the IC syndrome. Some of them seem to be part of a vicious cycle of the inflammatory reaction present. Detailed knowledge of the process of chronic inflammation can lead to treatments that may interrupt an inflammatory response. This might contribute to solving the pathogenic issue of IC and could be helpful in designing further investigations. Advances in understanding the causes of IC require objective criteria to subclassify the heterogenous patient cohort presently referred to as IC syndrome. Such subclassifications are a predisposition for pathogenic investigations and determining future treatment strategies.
    No preview · Article · Apr 2012 · Der Urologe
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    ABSTRACT: Im Gegensatz zur Ureterosigmoideostomie existieren keine verlässlichen klinischen Daten über das Tumorrisiko in den verschiedenen Formen der Harnableitung unter Verwendung isolierter Darmsegmente. In 44 urologischen Hauptabteilungen in Deutschland konnten Operationszahlen, die Operationsindikationen, Patientenalter und Operationsdaten der verschiedenen Formen der Harnableitung erfasst werden, die zwischen 1970 und 2007 operiert wurden. Ebenso wurden die bis 2009 aufgetretenen sekundären Tumoren in diesen Harnableitungen registriert und unter Bezug auf diese Operationszahlen die Tumorprävalenzen in den verschiedenen Harnableitungen ermittelt. In 17.758 Harnableitungen wurden insgesamt 32 sekundäre Tumoren beobachtet. Das Tumorrisiko in Ureterosigmoideostomien (22-fach) und Zystoplastiken (13-fach) ist signifikant höher als in allen anderen kontinenten Formen der Harnableitung wie Neoblasen und Pouches (p
    No preview · Article · Apr 2012 · Der Urologe
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    ABSTRACT: Germ cell cancer (GCC) is curable in metastatic stages. The International Germ Cell Cancer Collaborative Group (IGCCCG) reports a poor prognosis subgroup with a 5-year survival of 48%. High-dose chemotherapy with PBSC transplantation (HD-PBSCT) in these patients showed promising results in phase II, but failed to show significant advantage in randomized trials. We report our monocenter series of all poor and selected intermediate prognosis germ cell tumor patients treated with multiple-course HD-PBSCT and secondary surgery of remaining tissue. We performed a retrospective analysis of our complete series of 44 patients (40 poor prognosis and 4 intermediate prognosis) treated by HD-PBSCT as part of first-line therapy from 1999 to 2010. The CR rate after up to four cycles of HD-PBSCT and radical resection of residual manifestations was 73%. The 3-year survival rate was 79.5% (median follow-up of 51.5 months; range: 7-143 months). Disease-related death rate was 16%. HD-PBSCT-related death did not occur. One patient died postsurgery. Multiple courses of HD-PBSCT with radical secondary surgery is safe and effective in poor prognosis metastatic GCC. Despite disappointing phase III studies it is of high interest to further study this field.
    Full-text · Article · Feb 2012 · Bone marrow transplantation
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    ABSTRACT: To evaluate the safety and feasibility of laparoscopic adrenalectomy (LA) performed in several German centres with different laparoscopic experience, as LA has become the gold-standard approach for benign surgical adrenal disorders; however, for solitary metastasis or primary adrenal cancer its precise role is uncertain. The data of 363 patients who underwent a LA were prospectively collected in 23 centres. All centres were stratified into three groups according to their experience: group A (<10 LAs/year), group B (10-20 LAs/year) and group C (>20 LAs/year). In all, 15 centres used a transperitoneal approach, four a retroperitoneal approach and four both approaches. Demographic data, perioperative and postoperative variables, including operating time, surgical approach, tumour size, estimated blood loss, complications, hospital stay and histological tumour staging, were collected and analysed. The transperitoneal approach was used in 281 cases (77.4%) and the retroperitoneal approach was used in 82 patients (22.6%). In all, 263 of 363 lesions (72.5%) were benign and 100 (27.5%) were malignant. The mean (sd) operating time was 127.22 (55.56) min and 130.16 (49.88) min after transperitoneal and retroperitoneal LA, respectively. The mean complication rates for transperitoneal and retroperitoneal LA were 5% and 10.9%, respectively. LAs performed by urologists experienced in laparoscopy is safe for the removal of benign and malignant adrenal masses. LA for malignant adrenal tumours should be performed only in high-volume centres by a surgeon performing at least >10 LAs/year.
    No preview · Article · Apr 2011 · BJU International
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    ABSTRACT: A number of new agents have been approved for systemic therapy of metastatic renal cell carcinoma (mRCC) recently. Thereby, prognostic factors may aid in predicting the effectiveness of various treatment modalities in individual cases. Aim of this study was to determine the value of human leukocyte antigen (HLA) class II characteristics in predicting response of mRCC to combined immunochemotherapy (ICT). A retrospective study of 29 patients with mRCC treated with ICT was performed: 17 patients (group A) with long-term remission and 12 (group B) with progressive disease after ICT. DNA was used for high resolution typing of HLA-DRB1, -DRB3, -DRB4, -DRB5, -DQA1, and -DQB1. Statistical evaluation started with Classification and Regression Trees analysis. The assignment of single alleles to the groups was then aggregated to create a classification on a patients' basis. Finally, the accuracy of this test algorithm was evaluated. HLA-DRB1 (DRB1*0301*0401*0402*0407*1101*1501=progression) was the strongest discriminator between the 2 groups. The test algorithm defined all patients with at least one of these DRB1 alleles to be progressive after ICT. Thus, 12 of 12 patients of group B could have been identified as progressive (sensitivity=100%). However, only 10 of 17 patients of group A would have been identified as responding (specificity=58%). Thus, the test had a positive and negative predictive value of 63% and 100%, respectively. Approximately 5% to 10% of all patients with mRCC are able to benefit from ICT with long-term remission. HLA class II characteristics may aid in identifying this small subgroup of patients with mRCC.
    No preview · Article · Mar 2011 · Journal of immunotherapy (Hagerstown, Md.: 1997)
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    ABSTRACT: To investigate prognostic markers in patients with metastatic renal cell carcinoma (mRCC) undergoing treatment with the tyrosine kinase inhibitors (TKIs) sorafenib (So) or sunitinib (Su). Eighty-three patients with mRCC, who were treated at our institution between 2006 and 2009, were evaluated prospectively. Clinical and laboratory parameters were investigated, as well as, treatment-related adverse events. Subclinical hypothyroidism was characterized by serum TSH above the upper limit of normal and both total triiodothyronine (T3) and thyroxine (T4) within normal limits. Clinical hypothyroidism was defined as low serum T3 and T4 together with elevated TSH. Thirty-one (37.3%) patients received So, and 52 (62.7%) were treated with Su. In univariate analysis, the ECOG status (P < 0.0001) as well as MSKCC criteria (P = 0.003) and response to therapy (P < 0.0001) were associated with progression-free survival (PFS). Twenty-one of 66 (31.8%) evaluable patients developed hypothyroidism during treatment. Of those patients, 8/21 (38.1%) were treated with So and 13/21 (61.9%) with Su. Response rate in this subgroup was 49.2%. Hypothyroidism was associated with a longer PFS (16.0 ± 0.8 months vs. 6.0 ± 0.8 months, P = 0.032). Most patients [16/21 (76.2%)] developed abnormal TSH values during the first 4 weeks of treatment. Hormone replacement with l-thyroxine did not have an influence on survival. In multivariate analyses, only the ECOG status (ECOG 0/1 vs. ECOG 2, P = 0.018) and hypothyroidism (P = 0.01) were independent prognostic parameters. The development of hypothyroidism during treatment might be useful as a predictor of PFS for mRCC patients undergoing treatment with targeted agents.
    No preview · Article · Dec 2010 · World Journal of Urology
  • G Pühse · A Secker · S Kemper · L Hertle · S Kliesch
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    ABSTRACT: The aim of the study was to investigate prospectively the prevalence of testosterone deficiency (TD) in patients with testicular germ-cell cancer (TGCC) using longitudinal data. A total of 376 TGCC patients were evaluated for serum testosterone levels before, during and after the following therapies: cisplatin-based polychemotherapy, carboplatin monotherapy, radiotherapy or surgery only. Complete serial hormone analyses were performed on 160 patients (age: 33.8±9.1years, mean±SD). All patients received treatment according to the guidelines of the 'German Testicular Cancer Study Group' and the 'European Germ Cell Cancer Consensus Group' or within studies performed by the 'European Organisation for Research and Treatment of Cancer' and the 'Deutsche Krebsgesellschaft'. Main outcome measurements were sexual hormone profiles over time. Statistical analysis of 1831 testosterone serum levels over time revealed a persistent TD in 23.9% of seminoma and 26.2% of non-seminoma patients. TD was associated with subnormal residual testicular volumes (<12mL). In conclusion, TD rates are high in testis cancer patients. This is present at primary diagnosis and most likely related to testicular dysgenesis or atrophy. Our longitudinal evaluation indicates that treatment modalities have minor influence and effect on the persistently high rates of TD in TGCC patients.
    No preview · Article · Nov 2010 · International Journal of Andrology
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    ABSTRACT: The aim of the study was the determination of the negative predictive value of sextant core prostate biopsy. Prostate cancer was diagnosed in 126 patients by systematic ultrasound-guided sextant biopsy and was subsequently treated with radical prostatectomy. The prostatectomy specimens were examined histopathologically using the whole-mount section technique. 81 patients were diagnosed with unilateral and 45 with bilateral prostate cancer after biopsy. In 15/81 patients, the diagnosis of unilateral disease was confirmed by the whole-mount sections; 66 patients turned out to have bilateral disease. In 14/66 cases, the missed tumour foci were diminutive. In the remaining 52 patients, an erroneous diagnosis of unilateral prostate cancer had been made after biopsy, although the missed tumour foci were not diminutive. The negative predictive value of sextant core biopsy with respect to unilateral disease was 36%. An unexpectedly high number of tumour foci are missed by systematic ultrasound-guided sextant prostate biopsy.
    No preview · Article · May 2010 · Anticancer research
  • L Hertle · A van Ophoven
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    ABSTRACT: We have conducted a prospective open-label study to examine the safety and efficacy of the long-term administration of the tricyclic antidepressant amitriptyline in patients with interstitial cystitis (IC). Patients were stratified into 2 groups: an NIDDK group including patients fulfilling the NIDDK criteria for IC and a non-NIDDK group encompassing patients who presented the characteristic IC symptoms but met at least one of the NIDDK exclusion criteria. Amitriptyline was taken strictly at bedtime following an established self-titration protocol without a limitation of the maximum daily dosage. Patients reporting improvement in a global response assessment questionnaire were defined as treatment responders. Further efficacy measures included changes of pain and urgency, functional bladder capacity and frequency. Changes in the O'Leary-Sant IC index and rating of overall satisfaction with the therapeutic outcome are reported as well. The mean follow-up of the study was 19.0 +/- 12.5 months. The response rate was 64% (60 patients). Overall mean dosage was 55 mg (range: 12.5-150 mg). Side effects occurred in 79 patients (84%) (dry mouth: 79%, weight gain: 59%). Patient overall satisfaction with the therapeutic result was either excellent or good in 43 patients (46%). The drop-out rate was 31% (29 patients) after a mean treatment period of 6 weeks at a mean dosage of 70 mg. Non-response to treatment was the primary reason for drop-out in all cases, side effects contributed to drop-out in 25 patients (86%). The various IC symptoms improved statistically significant compared with baseline. Long-term administration of amitriptyline is a feasible, safe and effective treatment for IC provided that the drug is used judiciously to minimise adverse effects. The therapeutic response to amitriptyline was uniformly observed in patients fulfilling the NIDDK criteria and in those patients with the pure clinical diagnosis of IC.
    No preview · Article · Jan 2010 · Aktuelle Urologie
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    ABSTRACT: We examined papillary renal cell carcinoma prognostic variables and validated the 2002 UICC TNM staging system in a multicenter analysis. From 10 urological institutions in Germany followup data were collected on a total of 675 patients with papillary renal cell carcinoma. Central pathological review was done to validate external histopathological diagnoses. The Kaplan-Meier method was used to derive cumulative cancer specific and overall survival, and the log rank test was used to compare the curves of 2 or more groups. For multivariate analysis of prognostic factors Cox regression analysis was done. All proportional hazard assumptions were systemically verified using the Grambsch-Therneau test. Cancer specific survival was significantly related to TNM stage and histological grading on univariate and multivariate analyses. Five-year cancer specific survival in pT1b cases was significantly shorter than in pT1a cases (90.0% vs 98.3%, p = 0.017). No significant difference was found between pT1b and pT2 tumors. Patients with pT3 or greater disease were at high risk for metastasis (50.6%) while metastatic disease associated with pT2 or less tumors occurred in 7.8% (p <0.0001). After metastatic disease was present the prognosis was poor with 7.2% 5-year cancer specific survival. Age was associated with poor prognosis in the subgroup with pT3 or greater tumors on univariate analysis (p = 0.026) but not on multivariate analysis. In its current form the 2002 UICC TNM staging system is not applicable to papillary renal cell carcinoma. Clinical and radiological followup should be offered at frequent intervals to patients with venous thrombus and/or locally advanced disease. The role of age remains unclear but should not be underestimated in risk stratification after surgery.
    No preview · Article · Dec 2009 · The Journal of urology
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    ABSTRACT: For decades, advanced renal cancer was almost resistant to systemic therapy. Only a few patients with metastatic disease derived clinical benefit from immunotherapy after nephrectomy. Recent advances in understanding the molecular biology of advanced and metastatic renal cancer led to the development of several targeted agents that showed impressive anti-tumor efficacy and prolongation of progression-free survival. The integration of these drugs into clinical practice did not only revolutionize the management of renal cancer, but also created controversy about the necessity, patient selection for and timing of the extirpation of the primary tumor, as well as metastasectomy. Data from ongoing preclinical investigations, including basic science and translational research, are presented and carried forward into multimodal considerations to optimize clinical efficacy of concomitant surgical treatments in the era of targeted agents. In addition to these analyses, this article highlights available clinical data regarding the disputable importance of surgical treatment approaches and explores the need of multimodality treatment paradigms within interdisciplinary decision making.
    No preview · Article · Jul 2009 · Expert Review of Anti-infective Therapy
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    ABSTRACT: The endothelin axis consists of endothelin-1 (ET-1) and its two receptors, ET(A)- and ET(B)-receptor (ET(A)-R and ET(B)-R). In several tumor entities, the ET(A)-R plays a significant role as a drug target. In our study, we investigated whether inhibition of ET(A)-R with atrasentan leads to an antitumor effect in urinary bladder carcinoma as well. Twenty nude mice with thymic aplasia were subcutaneously administered 2 x 10(6) KU-19-19 bladder cancer cells in the right flank. Starting on the 22nd day after the injection, ten animals were treated with atrasentan (2.5 mg/kg BW intraperitoneally), and another ten animals were treated with placebo. During treatment, absolute tumor growth and relative growth rate over time were determined. After the end of treatment, the mitosis and necrosis rates, microvessel density, and receptor density in the tumor tissue were analyzed by immunohistochemistry. In addition, the expression intensities of ET-1, ET(A)-R, and ET(B)-R were evaluated semiquantitatively and compared between the groups. No significant differences between the active-treatment and placebo groups were detected, either with respect to absolute tumor growth (P = 0.333) or mitosis rate (P = 0.217). In the analysis of the necrosis rate and receptor density for ET(A)-R, a trend toward higher values in the active-treatment group (mean necrosis rate = 63.67%, receptor density: 1.417) than in the placebo group (mean necrosis rate = 46.25%, receptor density: 1.270) was found; however, neither difference was statistically significant (P = 0.08 and 0.219, respectively). ET(A)-R blockade with atrasentan in a bladder cancer xenograft model shows no significant antitumor effect.
    No preview · Article · Jun 2009 · Journal of Cancer Research and Clinical Oncology

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  • No preview · Article · Mar 2009 · European Urology Supplements
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    ABSTRACT: The vascular endothelial growth factors VEGF-C, VEGF-D and its receptor, VEGFR-3, are overexpressed in different malignancies and associated with lymph node metastasis and poor prognosis. We analysed these factors in clear cell (ccRCC) and papillary (pRCC) renal cell carcinoma (RCC). The results were correlated with various clinicopathological parameters (CPP). We constructed a tissue microarray with tumor samples of 135 (81%) ccRCC and 31 (19%) pRCC. After immunohistochemical staining using polyclonal antibodies for VEGF-C, VEGF-D and VEGFR-3, a semiquantitative analysis was performed to determine the levels of expression. The results were compared between the two subgroups and were correlated with CPP. In the two subgroups the expression of VEGF-C was significantly correlated with that of VEGF-D (p<0.001). There was an increased expression of VEGF-C in 11% of ccRCC and 36% of pRCC (p=0.002). VEGF-D expression was positive by means of analysis in 22% of ccRCC and 42% of pRCC (p=0.039). There was no significant difference regarding the expression of VEGFR-3 between the subgroups (44% ccRCC and 61% pRCC, p=0.11). No correlation was found between the expression of the analysed parameters and CPP (TNM, grading, progression-free survival and overall survival) in either the entire group or in the two subgroups. In summary, ccRCC and pRCC show a different expression pattern of the analysed lymphangiogenic factors. Further studies are necessary to confirm these results and to determine whether the VEGF-C/VEGF-D/VEGFR-3-axis can play a role as a prognostic tool or a target for therapeutic intervention in renal cell carcinoma.
    No preview · Article · Oct 2008 · Oncology Reports

Publication Stats

3k Citations
615.41 Total Impact Points

Institutions

  • 2002-2014
    • Universitätsklinikum Münster
      • • Klinik für Urologie
      • • Gerhard-Domagk-Institut für Pathologie
      Münster, North Rhine-Westphalia, Germany
  • 1992-2011
    • University of Münster
      • • Department of Urology
      • • Department of General and Visceral Surgery
      • • Gerhard-Domagk-Institute of Pathology
      • • Clinic for Urology
      • • Center of Reproductive Medicine and Andrology
      Muenster, North Rhine-Westphalia, Germany
  • 2007
    • EUREGIO-KLINIK Albert-Schweitzer-Straße GmbH
      Nordhorn, Lower Saxony, Germany
  • 2004
    • University of Innsbruck
      Innsbruck, Tyrol, Austria
  • 2000-2001
    • Universität Basel
      • Institute of Geology and Paleontology
      Bâle, Basel-City, Switzerland
  • 1999
    • University of Bonn
      Bonn, North Rhine-Westphalia, Germany
  • 1998
    • Universität Witten/Herdecke
      Witten, North Rhine-Westphalia, Germany
  • 1997
    • Christian-Albrechts-Universität zu Kiel
      Kiel, Schleswig-Holstein, Germany
  • 1985-1990
    • Ruhr-Universität Bochum
      • Neurological Clinic
      Bochum, North Rhine-Westphalia, Germany
  • 1984
    • Johannes Gutenberg-Universität Mainz
      Mayence, Rheinland-Pfalz, Germany