Abstract:
:Background Tumor grade is one of the more controversial factors, and the data regarding its prognostic impact in squamous cell carcinoma (SCC) of the uterine cervix are controversial. Methods The histological slides of 467 surgically treated FIGO stage IB1 to IIB cervical SCC were re-examined regarding the prognostic impact of the histological tumor grade based on the degree of keratinization (conventional tumor grade) according to the WHO recommendation on recurrence-free and overall survival as well as on the prediction of pelvic lymph node involvement. Results 46.0% presented with well-differentiated tumors (G1, n = 215), 30.6% with moderate (G2, n = 143) and 23.3% with poor differentiation (G3, n = 109). The recurrence-free survival was significantly reduced in patients with poorly differentiated tumors (G1: 81.4%, G2: 70.6%, G3: 64.2%; p = 0.008). There was no impact on overall survival. Because of the lack of survival differences between G1- and G2-tumors, they were merged into low-grade tumors, and their prognostic outcome was compared to the high-grade group (G3-tumors). Based on this binary conventional grading system there was a significantly longer recurrence-free (low-grade: 77.1% vs. high-grade: 64.2%; p = 0.008) and overall survival (low-grade: 76.0% vs. high-grade: 65.1%; p = 0.031) in the low-grade group. However, both the conventional three-tiered and the binary grading systems (separating tumors into a low- and high-grade group) failed to predict pelvic lymph node involvement (p = 0.9 and 0.76, respectively). Conclusion A binary grading model for the conventional tumor grade (based on the degree of keratinization) in SCC of the uterine cervix may be suitable for the prognostic survival evaluation but failed to predict pelvic lymph node involvement. :Hintergrund Tumorgrade gehören zu den umstrittenen Faktoren bei der Einschätzung von Tumoren, und die Daten zum prognostischen Effekt von Tumorgrading für das Plattenepithelkarzinom der Cervix uteri sind kontrovers. Methoden Die histologischen Präparate von 467 operativ behandelten FIGO-IB1- bis -IIB-Plattenepithelkarzinome der Cervix uteri wurden einer erneuten Untersuchung unterzogen. Untersucht wurde u. a. der prognostische Effekt des histologischen Tumorgrads, basierend auf das Ausmaß der Keratinisierung (konventionelles Tumorgrading) gemäß der WHO-Empfehlung zum rezidivfreien Überleben und Gesamtüberleben sowie die prognostische Aussagekraft von Grading im Hinblick auf den Lymphknotenbefall in der Beckenregion. Ergebnisse In 46,0% der Präparate war der Tumor gut differenziert (G1, n = 215), in 30,6% war er mäßiggradig differenziert (G2, n = 143), und in 23,3% der Fälle war der Tumor schlecht differenziert (G3, n = 109). Bei Patientinnen mit schlecht differenzierten Tumoren war das rezidivfreie Überleben deutlich reduziert (G1: 81,4%, G2: 70,6%, G3: 64,2%; p = 0,008). Es gab aber keine Auswirkungen auf das Gesamtüberleben. Weil es fast keinen Unterschied in den Überlebensraten zwischen G1- und G2-Tumoren gab, wurden diese als Low-Grade-Karzinome zusammengefasst, und das prognostische Ergebnis für diese Low-Grade-Tumoren wurde mit dem der High-Grade-Gruppe (G3-Tumoren) verglichen. Bei diesem binären konventionellen Gradingsystem war das rezidivfreie Überleben (Low-grade: 77,1% vs. High-grade: 64,2%; p = 0,008) und das Gesamtüberleben (Low-grade: 76,0% vs. High-grade: 65,1%; p = 0,031) der Low-Grade-Gruppe deutlich länger. Aber sowohl das konventionelle 3-stufige System als auch das binäre Gradingsystem (bei dem die Tumoren in Low-grade und High-grade unterteilt wurden) waren nicht in der Lage, prognostische Aussagen zum Befall von Beckenlymphknoten zu machen (p = 0,9 resp. 0,76). Schlussfolgerung Beim Plattenepithelkarzinom der Cervix uteri eignet sich ein binäres Gradingsystem für konventionelle Tumorgrade (basierend auf das Ausmaß der Keratinisierung) zwar für die prognostische Einschätzung des Überlebens, es ist aber nicht in der Lage, prognostische Aussagen zum Befall der Beckenlymphknoten zu machen.
journal_name
Geburtshilfe Frauenheilkdjournal_title
Geburtshilfe und Frauenheilkundeauthors
Brambs CE,Höhn AK,Hentschel B,Fischer U,Bilek K,Horn LCdoi
10.1055/a-0828-7681subject
Has Abstractpub_date
2019-02-01 00:00:00pages
198-204issue
2eissn
0016-5751issn
1438-8804pii
8287681journal_volume
79pub_type
杂志文章abstract::During an eight year period, 100 patients with the diagnosis of pre-eclampsia and HELLP syndrome were treated at the Departments of Obstetrics and Gynaecology of 2 University Hospitals (Technische Universität München and Universität Göttingen). The clinical treatment concepts, which were used in common at the two hosp...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2007-1023187
更新日期:1992-10-01 00:00:00
abstract::The author demonstrates - contrary to all existing opinions - that without doubt insulin demand increases very early and relative continually; it stagnates only in the last weeks of pregnancy. Therefore gravid women have a resource of insulin - sufficient to guarantee (for sake of fetus) a constant level of blood-gluc...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2008-1036811
更新日期:1981-05-01 00:00:00
abstract::Report of the case of a 22 year old primigravida. At 37 weeks gestation an ultra-sound examination was carried out because of fetal bradycardia. An atrial septal defect was found with a complete atrial ventricle canal. (AV canal). These findings were corroberated at autopsy in addition a polyspienic syndrome with mult...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2008-1036838
更新日期:1981-01-01 00:00:00
abstract::Holoprosencephaly is a malformation complex, in which the foetal forebrain (prosencephalon) fails to cleave. The aetiology of holoprosencephaly is heterogeneous. In the last years, a new malformation syndrome has been described, including holoprosencephaly, postaxial polydactyly, congenital heart defects and normal ka...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2007-1023813
更新日期:1992-12-01 00:00:00
abstract::Textbooks and literature reports frequently view the primipara of advanced age as a group being at increased risk of prolonged labor, dystocia, injuries to the birth canal and fetal distress. Particularly, a rigid cervix and reduced elasticity of the soft tissues of the birth canal are claimed responsible for these ri...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2008-1026496
更新日期:1988-04-01 00:00:00
abstract::The electrophoresis mobility test (EM) is credited with an accuracy of 70-90% for the diagnosis of gynaecological malignancies. The test was done in 21 patients with dysplasia of carcinoma in situ of the uterine cervix, 34 patients without malignant or pre-malignant gynaecological findings and 27 women who were not in...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2008-1037373
更新日期:1980-06-01 00:00:00
abstract::In the context of a report on a case in which the placenta was implanted at the uterine septum, the diagnosis, course of pregnancy, and obstetric management are described and discussed. In the case reported here this extremely rare nidation site led to premature detachment of the placenta during the last expulsive pai...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2008-1036502
更新日期:1985-12-01 00:00:00
abstract::A new tissue-selective prostaglandin E2-derivate, 16-Phenoxy-prostaglandin E2-methansulfonamide (SH B 286) developed by Pfizer, USA, and Schering, Germany, has been investigated as abortifacient using the intrauterine as well as intravenous route of application. Vital signs, intrauterine pressure, serum levels of ster...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:
更新日期:1977-12-01 00:00:00
abstract::Introduction There has been very little medical research into pregnancies which occur in the context of prostitution, even though the associated health risks for mother and child, e.g. violence or maternal drug abuse, are well known. The aim of this study was to compile and summarize what is known (inter-)nationally a...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:10.1055/s-0042-124045
更新日期:2017-04-01 00:00:00
abstract::In 30 sterility patients with normal course of the cycle, 17 OHP already rises significantly one day before the LH-peak. It influences not only progesterone and E2 but also hypothalamic opiate activity and LHRH and LH secretion. 17 OHP is on the one hand discussed as a further trigger for the LH peak and is on the oth...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2008-1035886
更新日期:1987-09-01 00:00:00
abstract::In the near future, important translational questions of clinical relevance will be adressed by studies currently in progress. On the one hand, the role of PD-L1 expression must be further understood, after it was found to be relevant in the use of atezolizumab in first-line therapy of patients with metastatic triple-...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:10.1055/a-1039-4458
更新日期:2019-12-01 00:00:00
abstract::In 966 patients who had undergone surgery and who had been suffering from squamous cell carcinoma, tumour recurrence occurred in 16.8% of the cases. In almost 70% of these cases, recurrence was seen in the first two years following treatment. 15% of the patients died of the carcinoma. Compared with the patients who ha...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2008-1036554
更新日期:1983-07-01 00:00:00
abstract::Our first 23 patients treated by this method were followed up by urodynamic assessment and urethrocystovaginography 13 months after the operation. Urodynamic assessment was performed according to the criteria of the International Continence Society. There was no statistically significant difference in the resting uret...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2008-1036004
更新日期:1988-06-01 00:00:00
abstract::Report on the rare event of a complete ischemia of the right arm immediately postpartum. The infant was delivered by Caesarean Section because of cervical dystocia and fetal distress. The umbilical cord was twice around the neck and the ischemia of the right arm appeared to be due to spasm of the axillary artery. Trea...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:
更新日期:1976-12-01 00:00:00
abstract::From 1976 through 1984, 48 primary caesarean hysterectomies were performed in the Department of Obstetrics and Gynaecology of the Medical School of Hannover. The indications for the operation, the risk factors and the postoperative course were analysed and compared with a control group of patients with a Caesarean sec...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2008-1036139
更新日期:1987-06-01 00:00:00
abstract::This case report its on a haemorrhagic shock developing after amniocentesis during early pregnancy. Initially caused by a lesion of a small subserous artery in the upper uterine fundal wall, the patient consequently developed a protracted haemorrhagic shock that required emergency treatment and surgery. Thirteen days ...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2007-1022812
更新日期:1995-07-01 00:00:00
abstract::In 270 cases of T1 and T2 carcinomas of the breast with ten or less axillary lymph nodes having been examined, the prognostic relevance of the histopathological statement of nodal negativity was assessed in a retrospective study. In this collective study, the mean number of lymph nodes examined was 4.1 +/- 1.9 for the...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2008-1035755
更新日期:1989-03-01 00:00:00
abstract::Objective The aim of this study was to determine the present oral health status of pregnant women depending on selected sociodemographic differences and deduce any resulting consequences for health prevention. Methods The participants' data of relevance to the study such as age, school leaving qualification, migration...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:10.1055/a-1205-0601
更新日期:2020-08-01 00:00:00
abstract::Besides typical gynaecological tumours colorectal neoplasms, Crohn's disease, dystopic kidneys, mesenteric cysts, tumours of the small bowel, perityphlitic abscesses, retroperitoneal sarcomas, lymphomas of the ileocoecal region and, in aged patients, aneurysmatic lesions of the iliac arteries have to be considered as ...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章,评审
doi:10.1055/s-2007-1022900
更新日期:1993-06-01 00:00:00
abstract::The concentration of hCG was measured in serum and peritoneal fluid (PF) of women with normal intrauterine pregnancy (34), extrauterine pregnancy (21), and intrauterine abortion (12) by two different methods. A new rapid, quantitative method (Spot-Test; ICON-QSR) which provides the results within 10 minutes was compar...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2008-1026529
更新日期:1988-07-01 00:00:00
abstract::In 170 primary invasive carcinomas of the breast, morphological criteria of the primary tumour--tumour size, WHO classification, malignancy according to Bloom, number and status of foci, lymphangiosis carcinomatosa, stroma reaction--were compared with the axillary lymph node status. In addition, the numbers of resecte...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2008-1036505
更新日期:1984-11-01 00:00:00
abstract::Purpose: In the years 1993-1996 a number of presumably false-positive breast cancer diagnoses were made by a pathologist in Essen. A follow-up, undertaken 15 years later, investigated how many women had tumour recurrence and/or metastasis or had died from breast cancer. Material and Methods: A total of 151 (68 %) out ...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:10.1055/s-0031-1298541
更新日期:2012-06-01 00:00:00
abstract::The confusion of terms between the radiological literature and the gynaecological and anatomical literature regarding the definitions of the infantile and the hypoplastic uterus are described. The history of this confusion is traced. The two types of uterus were clearly defined by K. Menge and K.v. Oettingen in 1930. ...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:
更新日期:1975-11-01 00:00:00
abstract::Pulsed Doppler velocimetry of the fetal aortic and pulmonary valves derived in the five-chamber-view and short-axis view were performed in 88 uncomplicated pregnancies between the 20th and 40th week of gestation. The maximal and mean velocities were assessed for both semilunar valves. Considering the valve diameters a...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2007-1023303
更新日期:1995-04-01 00:00:00
abstract::In 50 cases with an end-diastolic zero flow or reverse flow all antenatal and perinatal abnormalities have been recorded. The fetal outcome was registered. The percentage of highly dystrophic newborns (percentile less than 5) was 88%. The perinatal mortality counted up to 16% and the percentage of congenital malformat...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2008-1026313
更新日期:1991-04-01 00:00:00
abstract::In many cases, the sonography of the endometrium requires an exact pre-therapeutical interpretation. Apart from a hysteroscopy, this can take place by means of an improved version of a contrast hysterosonography, i.e. the Gel-KHSG. The technique and examination results are described here. This simple examination metho...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2007-1026180
更新日期:1991-06-01 00:00:00
abstract::Seasonal fluctuations in the sex ratio of new borns are investigated. The largest predominance of male deliveries over female deliveries was found to be during the conception months May-June with an almost constant number of deliveries. The highest value was in June. Seasonal maximum of the male to female sex ratio is...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:
更新日期:1979-03-01 00:00:00
abstract::In the present paper we examined, whether the combined GnRH-agonist/hMG therapy implies an increased risk of the ovarian hyperstimulation syndrome (OHS). In a retrospective analysis, 525 GnRH-a/hMG cycles were compared with 643 cycles of hMG stimulation, which were simultaneously performed at the Department of Gynecol...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2008-1026597
更新日期:1989-04-01 00:00:00
abstract::A laparotomy for a suspected cystic ovarian tumour which was thought to extent as far as the costal arch, was carried out on a 24-year-old patient with a long history of oligomenorrhea and sterility. Due to excessive oedema, both ovaries were tremendously enlarged. The right ovary was twisted 360 degrees. No haemorrha...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:
更新日期:1977-02-01 00:00:00
abstract::34 patients received an intravenous bolus injection of 2 g ceftizoxime over 5 min at various times before abdominal or vaginal hysterectomy. Ceftizoxime concentrations in myometrium were substantially higher than in salpinges and endometrium. Tissue concentrations of 4 micrograms/g could be maintained for at least 3 h...
journal_title:Geburtshilfe und Frauenheilkunde
pub_type: 杂志文章
doi:10.1055/s-2008-1036734
更新日期:1983-11-01 00:00:00