@phdthesis{Boldt2011,
  author    = {Boldt, Kristina},
  title     = {Vergleichende Untersuchung der prognostischen Relevanz von BNP, NT-proBNP, hsCRP und TNF-ɑ bei Patienten mit klinisch-anamnestischem Verdacht auf das Vorliegen einer Herzinsuffizienz in der Hausarztpraxis- : Follow-up-Untersuchung zur Grundstudie zur Objektivierung der kardiovaskul{\"a}ren Dysfunktion im ambulanten und haus{\"a}rztlichen Bereich mittels handgehaltener Echokardiographie und dem BNP-Schnelltest (Handheld-BNP-Studie)},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-65088},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2011},
  abstract  = {Herzinsuffizienz ist eine sehr h{\"a}ufige Erkrankung vor allem des h{\"o}heren Lebensalters. Biomarker wie NT-proBNP, BNP, hsCRP haben neben ihrer Bedeutung f{\"u}r die Diagnose einer akuten Herzinsuffizienz einen großen Stellenwert in der Absch{\"a}tzung der Prognose eines Patienten. Die prognostische Relevanz dieser Marker konnte auch bei nicht herzinsuffizienten, anderweitig kranken Patienten gezeigt werden. Unklar und wenig erforscht ist die Aussagekraft von Biomarkern in einem Kollektiv nicht akut dekompensierter Patienten, welche sich ambulant bei ihrem Hausarzt vorstellen. Die Handheld-BNP-Studie untersuchte im prim{\"a}r{\"a}rztlichen Bereich das diagnostische Potential von BNP und der miniaturisierten Echokardiographie. Die vorliegende Follow-up-Studie untersucht die prognostische Relevanz von BNP sowie vergleichend den prognostischen Wert von NT-proBNP und der Kardiologendiagnose. Auch die prognostische Aussagekraft der inflammatorischen Marker hsCRP und TNF-ɑ, ebenso wie die Frage, ob durch eine Kombination der Marker die prognostische Absch{\"a}tzung weiter gesteigerter werden kann, ist Gegenstand dieser Arbeit. Zuletzt wurde eine multivariate Regressionsanalyse durchgef{\"u}hrt, um den unabh{\"a}ngigen prognostischen Wert der Biomarker zu untersuchen. Es konnte gezeigt werden, dass bei diagnostisch naiven Patienten mit dem klinisch-anamnestischen Verdacht auf das Vorliegen einer Herzinsuffizienz das kardiale wie auch das nicht-kardiale Mortalit{\"a}tsrisiko sowie die Rate an Hospitalisierungen gegen{\"u}ber der Allgemeinbev{\"o}lkerung gleichen Alters erh{\"o}ht sind, unabh{\"a}ngig vom Vorliegen einer Herzinsuffizienz. Eine Bestimmung der Biomarker BNP, NT-proBNP, hsCRP und TNF-ɑ erwies sich in diesem Kollektiv als hilfreich, diejenigen mit erh{\"o}htem Risiko zu erkennen.},
  subject      = {BNP},
  language  = {de}
}
@article{LippertFassnachtRonchi2022,
  author    = {Lippert, Juliane and Fassnacht, Martin and Ronchi, Cristina L.},
  title     = {The role of molecular profiling in adrenocortical carcinoma},
  series = {Clinical Endocrinology},
  volume    = {97},
  journal   = {Clinical Endocrinology},
  number    = {4},
  doi       = {10.1111/cen.14629},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-258382},
  pages     = {460-472},
  year      = {2022},
  abstract  = {Adrenocortical carcinoma (ACC) is a rare, aggressive cancer with still partially unknown pathogenesis, heterogenous clinical behaviour and no effective treatment for advanced stages. Therefore, there is an urgent clinical unmet need for better prognostication strategies, innovative therapies and significant improvement of the management of the individual patients. In this review, we summarize available studies on molecular prognostic markers and markers predictive of response to standard therapies as well as newly proposed drug targets in sporadic ACC. We include in vitro studies and available clinical trials, focusing on alterations at the DNA, RNA and epigenetic levels. We also discuss the potential of biomarkers to be implemented in a clinical routine workflow for improved ACC patient care.},
  language  = {en}
}
@phdthesis{Verburg2008,
  author    = {Verburg, Frederik Anton},
  title     = {The course of differentiated thyroid carcinoma in patients in whom the initial I-131 ablative treatment was successful},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-33346},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2008},
  abstract  = {Objective: The objective of this study was to study recurrence in patients with differentiated thyroid carcinoma who after initial therapy consisting of total thyroidectomy and I-131 ablation, were cured defined as a negative TSH-stimulated Tg-levels and a negative I-131 whole body scan (WBS) at the first follow-up after ablation. Methods: Retrospective data for differentiated thyroid carcinoma patients from three university hospitals were pooled. Out of 1993 patients, 526 cured patients were included. All patients received at least one more TSH-stimulated WBS and Tg-measurement within 5 years after initial treatment. Results: 12 patients (2.1\%) developed a recurrence after an average interval of 35 months (range: 12-59 months) following administration I-131 ablation. Overall disease-free survival according to the method of Kaplan-Meier was 96.6\%. There was no difference in disease-free survival between high- and low-risk patients (p=0.61). Recurrence was first discovered by Tg-measurement during levothyroxin therapy in 7 patients, and by TSH-stimulated Tg-measurement in 5 patients. I-131 WBS did not contribute to the detection of recurrences. Multivariate analysis showed that age TNM-stage (p=0.015) and histology (p=0.032) were independent predictors of disease-free survival. Conclusion: Recurrence is a rare event in patients with DTC who received total thyroidectomy with subsequent I-131 ablation, and who had a negative first follow-up TSH-stimulated I-131 WBS and negative concurrent Tg. In the study population there were no recurrences after more than 5 years of follow-up.},
  subject      = {Schilddr{\"u}senkrebs},
  language  = {en}
}
@article{ZhouWuchterEgereretal.2019,
  author    = {Zhou, Xiang and Wuchter, Patrick and Egerer, Gerlinde and Kriegsmann, Mark and Mataityte, Aiste and Koelsche, Christian and Witzens-Harig, Mathias and Kriegsmann, Katharina},
  title     = {Role of virological serum markers in patients with both hepatitis B virus infection and diffuse large B-cell lymphoma},
  series = {European Journal of Haematology},
  volume    = {103},
  journal   = {European Journal of Haematology},
  number    = {4},
  doi       = {10.1111/ejh.13300},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-258442},
  pages     = {410-416},
  year      = {2019},
  abstract  = {Background Causality between hepatitis B virus (HBV) infection and diffuse large B-cell lymphoma (DLBCL) was reported in various studies. However, the implication of different virological serum markers of HBV infection in patients with both HBV infection and DLBCL is not fully understood. The aim of this study was to investigate the impact of HBV markers on overall survival (OS) and progression-free survival (PFS) in patients with both HBV infection and DLBCL. Methods In this study, patients (n = 40) diagnosed with both HBV infection and DLBCL were identified between 2000 and 2017. Six patients with hepatitis C virus (HCV) and/or human immunodeficiency virus (HIV) co-infection were excluded from this study. We retrospectively analyzed patients' demographic characteristics, treatment, and the prognostic impact of different HBV markers at first diagnosis of DLBCL (HBsAg, anti-HBs, HBeAg, anti-HBe, and HBV-DNA) on OS and PFS. Results The majority of patients (n = 21, 62\%) had advanced disease stage (III/IV) at diagnosis. In the first-line therapy, 24 patients (70\%) were treated with R-CHOP regimen (rituximab, cyclophosphamide, hydroxydaunorubicin, vincristine, and prednisolone). HBeAg positive patients had a trend toward inferior OS and PFS compared with HBeAg negative patients. Anti-HBe positive patients had a statistically significant better OS and PFS compared with anti-HBe negative group (both P < .0001). Viremia with HBV-DNA ≥ 2 × 107 IU/L had a significant negative impact on OS and PFS (both P < .0001). Conclusion High activity of viral replication is associated with a poor survival outcome of patients with both HBV infection and DLBCL.},
  language  = {en}
}
@article{MuellerThomasRudeliusRondaketal.2014,
  author    = {M{\"u}ller-Thomas, Catharina and Rudelius, Martina and Rondak, Ina-Christine and Haferlach, Torsten and Schanz, Julie and Huberle, Christina and Schmidt, Burkard and Blaser, Rainer and Kremer, Marcus and Peschel, Christian and Germing, Ulrich and Platzbecker, Uwe and Goetze, Katharina},
  title     = {Response to azacitidine is independent of p53 expression in higher-risk myelodysplastic syndromes and secondary acute myeloid leukemia},
  series = {HAEMATOLOGICA},
  volume    = {99},
  journal   = {HAEMATOLOGICA},
  number    = {10},
  issn      = {1592-8721},
  doi       = {10.3324/haematol.2014.104760},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-115313},
  pages     = {E179-E181},
  year      = {2014},
  abstract  = {No abstract available.},
  language  = {en}
}
@article{AltieriLaSalviaModicaetal.2023,
  author    = {Altieri, Barbara and La Salvia, Anna and Modica, Roberta and Marciello, Francesca and Mercier, Olaf and Filosso, Pier Luigi and de Latour, Bertrand Richard and Giuffrida, Dario and Campione, Severo and Guggino, Gianluca and Fadel, Elie and Papotti, Mauro and Colao, Annamaria and Scoazec, Jean-Yves and Baudin, Eric and Faggiano, Antongiulio},
  title     = {Recurrence-free survival in early and locally advanced large cell neuroendocrine carcinoma of the lung after complete tumor resection},
  series = {Journal of Personalized Medicine},
  volume    = {13},
  journal   = {Journal of Personalized Medicine},
  number    = {2},
  issn      = {2075-4426},
  doi       = {10.3390/jpm13020330},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-304000},
  year      = {2023},
  abstract  = {Background: Large Cell Neuroendocrine Carcinoma (LCNEC) is a rare subtype of lung cancer with poor clinical outcomes. Data on recurrence-free survival (RFS) in early and locally advanced pure LCNEC after complete resection (R0) are lacking. This study aims to evaluate clinical outcomes in this subgroup of patients and to identify potential prognostic markers. Methods: Retrospective multicenter study including patients with pure LCNEC stage I-III and R0 resection. Clinicopathological characteristics, RFS, and disease-specific survival (DSS) were evaluated. Univariate and multivariate analyses were performed. Results: 39 patients (M:F = 26:13), with a median age of 64 years (44-83), were included. Lobectomy (69.2\%), bilobectomy (5.1\%), pneumonectomy (18\%), and wedge resection (7.7\%) were performed mostly associated with lymphadenectomy. Adjuvant therapy included platinum-based chemotherapy and/or radiotherapy in 58.9\% of cases. After a median follow-up of 44 (4-169) months, the median RFS was 39 months with 1-, 2- and 5-year RFS rates of 60.0\%, 54.6\%, and 44.9\%, respectively. Median DSS was 72 months with a 1-, 2- and 5-year rate of 86.8, 75.9, and 57.4\%, respectively. At multivariate analysis, age (cut-off 65 years old) and pN status were independent prognostic factors for both RFS (HR = 4.19, 95\%CI = 1.46-12.07, p = 0.008 and HR = 13.56, 95\%CI 2.45-74.89, p = 0.003, respectively) and DSS (HR = 9.30, 95\%CI 2.23-38.83, p = 0.002 and HR = 11.88, 95\%CI 2.28-61.84, p = 0.003, respectively). Conclusion: After R0 resection of LCNEC, half of the patients recurred mostly within the first two years of follow-up. Age and lymph node metastasis could help to stratify patients for adjuvant therapy.},
  language  = {en}
}
@article{EiseleBlozikStoerketal.2013,
  author    = {Eisele, Marion and Blozik, Eva and St{\"o}rk, Stefan and Tr{\"a}der, Jens-Martin and Herrmann-Lingen, Christoph and Scherer, Martin},
  title     = {Recognition of depression and anxiety and their association with quality of life, hospitalization and mortality in primary care patients with heart failure - study protocol of a longitudinal observation study},
  series = {BMC Family Practice},
  volume    = {14},
  journal   = {BMC Family Practice},
  number    = {180},
  issn      = {1471-2296},
  doi       = {10.1186/1471-2296-14-180},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-121881},
  year      = {2013},
  abstract  = {Background: International disease management guidelines recommend the regular assessment of depression and anxiety in heart failure patients. Currently there is little data on the effect of screening for depression and anxiety on the quality of life and the prognosis of heart failure (HF). We will investigate the association between the recognition of current depression/anxiety by the general practitioner (GP) and the quality of life and the patients' prognosis. Methods/Design: In this multicenter, prospective, observational study 3,950 patients with HF are recruited by general practices in Germany. The patients fill out questionnaires at baseline and 12-month follow-up. At baseline the GPs are interviewed regarding the somatic and psychological comorbidities of their patients. During the follow-up assessment, data on hospitalization and mortality are provided by the general practice. Based on baseline data, the patients are allocated into three observation groups: HF patients with depression and/or anxiety recognized by their GP (P+/+), those with depression and/or anxiety not recognized (P+/-) and patients without depression and/or anxiety (P-/-). We will perform multivariate regression models to investigate the influence of the recognition of depression and/or anxiety on quality of life at 12 month follow-up, as well as its influences on the prognosis (hospital admission, mortality). Discussion: We will display the frequency of GP-acknowledged depression and anxiety and the frequency of installed therapeutic strategies. We will also describe the frequency of depression and anxiety missed by the GP and the resulting treatment gap. Effects of correctly acknowledged and missed depression/anxiety on outcome, also in comparison to the outcome of subjects without depression/anxiety will be addressed. In case results suggest a treatment gap of depression/anxiety in patients with HF, the results of this study will provide methodological advice for the efficient planning of further interventional research.},
  language  = {en}
}
@phdthesis{Bauer2004,
  author    = {Bauer, Andrea},
  title     = {Prognostische und therapeutische Aspekte von Thymomen : eine retrospektive Studie von 582 F{\"a}llen},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-12041},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2004},
  abstract  = {Thymome sind seltene epitheliale Thymustumoren, die in der {\"u}berwiegenden Zahl der F{\"a}lle die F{\"a}higkeit zur Reifung und zum Export von T-Zellen behalten haben. Diese F{\"a}higkeit ist als Ursache f{\"u}r die h{\"a}ufige Asoziation dieser Tumoren mit Autoimmunph{\"a}nomenen (z.B Myasthenia gravis)anzunehmen. Die vorgelegte Studie zeigt die prognostische Relevanz der derzeit g{\"u}ltigen histologischen WHO-Klassifizierung von Thymomen. Das biologische Verhalten der einzelnen Thymomtypen korreliert dabei mit dem Ausmaß zytogenetischer Ver{\"a}nderungen. Wenige klinische und histologische Parameter wie der histologische Subtyp, Tumorstadium nach Masaoka sowie der Resektionsstatus reichen aus, um den Verlauf eines bestimmten Thymoms mit gen{\"u}gender Zuverl{\"a}ssigkeit prognostizieren zu k{\"o}nnen. Dies konnte in {\"U}bereinstimmung mit fr{\"u}heren Arbeiten in unserer Studie gezeigt werden. Somit m{\"u}ssen vor allem diese drei Parameter ber{\"u}cksichtigt werden, um eine ad{\"a}quate Therapie einleiten zu k{\"o}nnen. Angaben zu Alters- und Geschlechtsverteilung k{\"o}nnen diese Befunde erg{\"a}nzen, haben jedoch keine prognostische Signifikanz f{\"u}r die Wahl der Therapie. Die erhobenen Befunde der vorgelegten Follow-up Studie k{\"o}nnen als Grundlage prospektiver klinischer Therapiestudien dienen. Im Zentrum der Bem{\"u}hungen sollte hierbei nach unseren Ergebnissen die Therapie von „high-risk" Thymomen des Typ B und C stehen, bei denen eine prim{\"a}re vollst{\"a}ndige Resektion nicht m{\"o}glich ist, oder bei denen zum Zeitpunkt der Operation bereits Metastasen bestehen. Therapieoptionen mit multimodalen Therapiestrategien m{\"u}ssen daf{\"u}r noch weiter modifiziert und {\"u}ber l{\"a}ngere Zeitr{\"a}ume erprobt werden. Zudem sollten klinische Studien mit Somatostatin-Analoga als neue Therapiem{\"o}glichkeit gef{\"o}rdert werden. Aufgrund der {\"a}ußerst niedrigen Inzidenz von Thymomen und der niedrigen Frequenz von Patienten mit diesen ung{\"u}nstigen Thymomverl{\"a}ufen werden diese Versuche nationale oder internationale Bem{\"u}hungen erfordern.},
  language  = {de}
}
@phdthesis{Offenberger2011,
  author    = {Offenberger, Katrin},
  title     = {Prognosefaktoren des differenzierten Schilddr{\"u}senkarzinoms : Retrospektive Analyse bei 1174 Patienten des interdisziplin{\"a}ren Tumorregisters der Universit{\"a}t W{\"u}rzburg},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-65534},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2011},
  abstract  = {In der vorliegenden retrospektiven Analyse wurden Prognosefaktoren des differenzierten Schilddr{\"u}senkarzinomes untersucht anhand eines Patientenkollektiv von 1174 Patienten, die im Zeitraum von 01.01.1980 bis 31.12.2004 an der Klinik und Poliklinik f{\"u}r Nuklearmedizin der Universit{\"a}t W{\"u}rzburg eine Behandlung erhielten bzw. betreut wurden. Analysiert wurden sowohl tumorbezogene Prognosefaktoren wie Histologie, Tumorstadien, Lymphknotenstatus und Fernmetastasierung, zudem patientenspezifische Faktoren wie Alter und Geschlecht. Bez{\"u}glich dieser Prognosefaktoren konnten wir die Daten fr{\"u}herer Jahre am Patientengut der W{\"u}rzburger nuklearmedizinischen Klinik best{\"a}tigen. Außerdem wurde die Auswirkung auf das krankheitsfreie {\"U}berleben in Abh{\"a}ngigkeit der postoperativen Tumorfreiheit und nach einer erfolgten Radioiodtherapie untersucht. Die Ergebnisse werden kritisch in den Kontext der aktuellen Studienlage gestellt.},
  subject      = {Schilddr{\"u}se},
  language  = {de}
}
@article{LiuHuStoerketal.2014,
  author    = {Liu, Dan and Hu, Kai and St{\"o}rk, Stefan and Herrmann, Sebastian and Kramer, Bastian and Cikes, Maja and Gaudron, Philipp Daniel and Knop, Stefan and Ertl, Georg and Bijnens, Bart and Weidemann, Frank},
  title     = {Predictive Value of Assessing Diastolic Strain Rate on Survival in Cardiac Amyloidosis Patients with Preserved Ejection Fraction},
  series = {PLOS ONE},
  volume    = {9},
  journal   = {PLOS ONE},
  number    = {12},
  issn      = {1932-6203},
  doi       = {10.1371/journal.pone.0115910},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-118024},
  year      = {2014},
  abstract  = {Objectives: Since diastolic abnormalities are typical findings of cardiac amyloidosis (CA), we hypothesized that speckle-tracking-imaging (STI) derived longitudinal early diastolic strain rate (LSRdias) could predict outcome in CA patients with preserved left ventricular ejection fraction (LVEF >50\%). Background: Diastolic abnormalities including altered early filling are typical findings and are related to outcome in CA patients. Reduced longitudinal systolic strain (LSsys) assessed by STI predicts increased mortality in CA patients. It remains unknown if LSRdias also related to outcome in these patients. Methods: Conventional echocardiography and STI were performed in 41 CA patients with preserved LVEF (25 male; mean age 65±9 years). Global and segmental LSsys and LSRdias were obtained in six LV segments from apical 4-chamber views. Results: Nineteen (46\%) out of 41 CA patients died during a median of 16 months (quartiles 5-35 months) follow-up. Baseline mitral annular plane systolic excursion (MAPSE, 6±2 vs. 8±3 mm), global LSRdias and basal-septal LSRdias were significantly lower in non-survivors than in survivors (all p<0.05). NYHA class, number of non-cardiac organs involved, MAPSE, mid-septal LSsys, global LSRdias, basal-septal LSRdias and E/LSRdias were the univariable predictors of all-cause death. Multivariable analysis showed that number of non-cardiac organs involved (hazard ratio [HR] = 1.96, 95\% confidence interval [CI] 1.17-3.26, P = 0.010), global LSRdias (HR = 7.30, 95\% CI 2.08-25.65, P = 0.002), and E/LSRdias (HR = 2.98, 95\% CI 1.54-5.79, P = 0.001) remained independently predictive of increased mortality risk. The prognostic performance of global LSRdias was optimal at a cutoff value of 0.85 S-1 (sensitivity 68\%, specificity 67\%). Global LSRdias <0.85 S-1 predicted a 4-fold increased mortality in CA patients with preserved LVEF. Conclusions: STI-derived early diastolic strain rate is a powerful independent predictor of survival in CA patients with preserved LVEF.},
  language  = {en}
}
@article{BaurBuentemeyerMegerleetal.2017,
  author    = {Baur, Johannes and B{\"u}ntemeyer, Tjark-Ole and Megerle, Felix and Deutschbein, Timo and Spitzweg, Christine and Quinkler, Marcus and Nawroth, Peter and Kroiss, Matthias and Germer, Christoph-Thomas and Fassnacht, Martin and Steger, Ulrich},
  title     = {Outcome after resection of Adrenocortical Carcinoma liver metastases: a retrospective study},
  series = {BMC Cancer},
  volume    = {17},
  journal   = {BMC Cancer},
  number    = {522},
  doi       = {10.1186/s12885-017-3506-z},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-159409},
  year      = {2017},
  abstract  = {Background: Metastatic Adrenocortical Carcinoma (ACC) is a rare malignancy with a poor 5-year-survival rate (<15\%). A surgical approach is recommended in selected patients if complete resection of distant metastasis can be achieved. To date there are only limited data on the outcome after surgical resection of hepatic metastases of ACC. Methods: A retrospective analysis of the German Adrenocortical Carcinoma Registry was conducted. Patients with liver metastases of ACC but without extrahepatic metastases or incomplete tumour resection were included. Results: Seventy-seven patients fulfilled these criteria. Forty-three patients underwent resection of liver metastases of ACC. Complete tumour resection (R0) could be achieved in 30 (69.8\%). Median overall survival after liver resection was 76.1 months in comparison to 10.1 months in the 34 remaining patients with unresected liver metastases (p < 0.001). However, disease free survival after liver resection was only 9.1 months. Neither resection status (R0/R1) nor extent of liver resection were significant predictive factors for overall survival. Patients with a time interval to the first metastasis/recurrence (TTFR) of greater than 12 months or solitary liver metastases showed significantly prolonged survival. Conclusions: Liver resection in the case of ACC liver metastases can achieve long term survival with a median overall survival of more than 5 years, but disease free survival is short despite metastasectomy. Time to recurrence and single versus multiple metastases are predictive factors for the outcome.},
  language  = {en}
}
@article{HerbertHirzleBartmannetal.2023,
  author    = {Herbert, Saskia-Laureen and Hirzle, Paula and Bartmann, Catharina and Schlaiß, Tanja and Kiesel, Matthias and Curtaz, Carolin and L{\"o}b, Sanja and W{\"o}ckel, Achim and Diessner, Joachim},
  title     = {Optimized process quality in certified breast centers through adherence to stringent diagnostic and therapeutic algorithms effects of structural as well as socio-demographic factors on start of therapy},
  series = {Archives of Gynecology and Obstetrics},
  volume    = {307},
  journal   = {Archives of Gynecology and Obstetrics},
  number    = {4},
  doi       = {10.1007/s00404-022-06666-2},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-324057},
  pages     = {1097-1104},
  year      = {2023},
  abstract  = {Purpose An increasing incidence of breast cancer can be observed worldwide. Since a delay of therapy can have a negative impact on prognosis, timely cancer care is an important quality indicator. By receiving treatment at a certified breast cancer center, the patient has the best chance of treatment in accordance with guidelines and the best prognosis. The identification of risk factors for a delay of therapy is of central importance and should be the basis for a continuous optimization of treatment at breast cancer centers. Methods This retrospective study included women with breast cancer (primary diagnosis, relapse, or secondary malignancy) at the University Hospital W{\"u}rzburg in 2019 and 2020. Data were retrieved from patients' records. Correlations and regression analyses were performed to detect potential risk factors for treatment delay. Results Patients who received the histological confirmation of breast cancer at an external institution experienced a later therapy start than those patients who received the histological confirmation at the University Hospital W{\"u}rzburg itself. (35.7 vs. 32.2 days). The interval between histological confirmation and the first consultation at the University Hospital W{\"u}rzburg correlated statistically significant with age, distress and distance to the hospital. Conclusion Patients with an in-house diagnosis of breast cancer are treated more quickly than those whose diagnosis was confirmed in an external institution. We identified factors such as increased age, greater distance to the hospital as well as increased distress to prolong the time until start of oncological treatment. Intensified patient care should be offered to these subgroups.},
  language  = {en}
}
@phdthesis{Weisensee2007,
  author    = {Weisensee, Tim Andr{\´e}},
  title     = {Nutzen von Stroke-Unit-Behandlung f{\"u}r die geriatrische Rehabilitationsprognose},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-24937},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2007},
  abstract  = {Die vorliegende Arbeit {\"u}berpr{\"u}ft an einem nach Alter, Geschlecht, Barthel-Index und Mini-Mental-State-Test gematchten geriatrischen Patientenkollektiv mit erstmaligem Schlaganfall die Wirksamkeit einer vorausgegangenen Akutbehandlung an einer Stroke Unit (n=59) gegen{\"u}ber einer allgemeinen (internistischen oder neurologischen) station{\"a}ren Akutbehandlung (n=59) f{\"u}r die Prognose im Laufe einer nachfolgenden geriatrischen Rehabilitationsbehandlung. Hintergrund dieser Frage ist der erh{\"o}hte {\"o}konomische Druck im Gesundheitswesen, der eine Effizienzpr{\"u}fung einer personell, technisch und logistisch aufw{\"a}ndigeren und damit teureren Behandlung auf einer Spezialstation verlangt. Bei Anwendung zahlreicher funktioneller Skalen und Erhebung einiger sozio{\"o}konomischer Faktoren zeigte sich auf Signifikanzniveau, dass die auf Stroke Unit Vorbehandelten bei Aufnahme in die Rehabilitation motorisch schwerer beeintr{\"a}chtigt waren (timed up and go-Test p=0,044, Lachs-Test p=0,34) und sich dann ausgepr{\"a}gter (Transferleistung p=0,024) auf ein bei Rehabilitationsende schließlich vergleichbares Leistungsniveau verbesserten. Die urspr{\"u}nglich geplante Langzeiteffizienzbetrachtung im Gruppenvergleich scheiterte an Datenschutzbedenken. Gesundheits{\"o}konomisch relevant ist, dass die Vorverweildauer im Akutkrankenhaus bei Stroke Unit-Patienten sechs Tage k{\"u}rzer war, die Rehabilitationsdauer allerdings vier Tage l{\"a}nger. Weitergehende Kostenbetrachtungen scheiterten am Unwillen zur Leistungsoffenlegung verschiedener Beteiligter im Gesundheitssystem. Eine plausible Erkl{\"a}rung f{\"u}r diese positive motorische Leistungsweiterentwicklung nach Stroke Unit-Vorbehandlung kann in einer fr{\"u}hzeitigeren und effektiveren Anstrengung durch Krankengymnastik, Ergotherapie, Logop{\"a}die, aktivierende Pflege, „enriched environment" gesucht werden, die sich positiv auf die Plastizit{\"a}t im Gehirn als wesentliche Bedingung zur Funktionswiedergewinnung auswirken k{\"o}nnte, was aber noch umstritten ist und Ziel weiterer Untersuchungen sein muss.},
  subject      = {Geriatrie},
  language  = {de}
}
@phdthesis{Ahnert2005,
  author    = {Ahnert, Jutta},
  title     = {Motorische Entwicklung vom Vorschul- bis ins fr{\"u}he Erwachsenenalter - Einflussfaktoren und Prognostizierbarkeit},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-16346},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2005},
  abstract  = {Langfristige Prognosen sportmotorischer Leistungen sowie die Kenntnis relevanter Einflussfaktoren auf die motorische Entwicklung gewinnen angesichts des ver{\"a}nderten Bewegungsverhaltens und der Zunahme motorischer Defizite von Kindern und Jugendlichen immer st{\"a}rker an Bedeutung. Der bisherige Forschungsstand zur Stabilit{\"a}t und Vorhersage sportlicher Leistungsf{\"a}higkeit beschr{\"a}nkt sich bisher jedoch fast ausschließlich auf retrospektive Studien oder aber auf L{\"a}ngsschnittstudien, die nur einen begrenzten Lebensabschnitt erfassen. Im Vordergrund der vorliegenden multivariaten L{\"a}ngsschnittstudie steht die empirische Analyse potentieller personinterner und personexterner Einflussfaktoren auf die Entwicklung motorischer - insbesondere koordinativer - F{\"a}higkeiten vom Vorschul- bis ins fr{\"u}he Erwachsenenalter. Außerdem sollte versucht werden, die Auspr{\"a}gung sportlicher Aktivit{\"a}t und motorischer F{\"a}higkeiten im fr{\"u}hen Erwachsenenalter m{\"o}glichst gut durch potentielle Pr{\"a}diktoren aus der Kindheit vorherzusagen. Als theoretischer Rahmen wurde ausgehend von einem f{\"a}higkeitsorientierten Ansatz das transaktionale Handlungsmodell von Baur (1989, 1994) ausgew{\"a}hlt, das sowohl endogene als auch exogene Einflussfaktoren auf die motorische Entwicklung ber{\"u}cksichtigt. Die Daten zur motorischen, somatischen und psychischen Entwicklung wurden im Rahmen der M{\"u}nchner L{\"a}ngsschnittstudie zur Genese individueller Kompetenzen (LOGIK) an 152 M{\"a}dchen und Jungen im Alter von 4, 5, 6, 8, 10, 12 und 23 Jahren erhoben. Es zeigen sich bereits im Vorschulalter substantielle Stabilit{\"a}tskoeffizienten zu den motorischen Leistungen im fr{\"u}hen Erwachsenenalter, die ab dem Grundschulalter auf mittelhohe Werte ansteigen. Als bedeutsame Einflussfaktoren auf die motorische Entwicklung erweisen sich neben der sportlichen Aktivit{\"a}t und dem BMI auch die nonverbale Intelligenz und das athletische Selbstkonzept. In Abh{\"a}ngigkeit von der Schullaufbahn, dem sozio{\"o}konomischen Status sowie der Sportvereinszugeh{\"o}rigkeit k{\"o}nnen Unterschiede im motorischen Entwicklungsverlauf nur zum Teil nachgewiesen werden. Einen nachhaltigen Einfluss auf die motorische Entwicklung bis ins fr{\"u}he Erwachsenenalter besitzt dagegen das fr{\"u}he sportive Anregungsniveau im Elternhaus. Mittels schrittweiser Regression k{\"o}nnen unter Einbezug motorischer, somatischer, kognitiver, pers{\"o}nlichkeitsbezogener und soziodemographischer Merkmale im Vorschulalter bereits bis zu 31\%, ab dem Grundschulalter bis zu 46\% der Varianz motorischer Leistungen mit 23 J. aufgekl{\"a}rt werden. F{\"u}r eine befriedigende Prognose sp{\"a}terer motorischer Leistungen sollten deshalb neben den motorischen Leistungskomponenten auch somatische, kognitive, pers{\"o}nlichkeitsbezogene und sozialisationsbedingte Einfl{\"u}sse ber{\"u}cksichtigt werden. Die relativ hohe Stabilit{\"a}t motorischer F{\"a}higkeiten ab dem Grundschulalter deutet darauf hin, dass bereits in der Kindheit die Grundlagen f{\"u}r die weitere motorische Entwicklung gelegt werden. Ein effizienter Ansatzpunkt zur Intervention scheint hier vor allem die F{\"o}rderung von sportlicher Aktivit{\"a}t und Sportinteresse im Elternhaus zu sein.},
  subject      = {Motorische Entwicklung},
  language  = {de}
}
@article{KneitzKalogirouSpahnetal.2013,
  author    = {Kneitz, Burkhard and Kalogirou, Charis and Spahn, Martin and Krebs, Markus and Joniau, Steven and Lerut, Evelyne and Burger, Maximilian and Scholz, Claus-J{\"u}rgen and Kneitz, Susanne and Riedmiller, Hubertus},
  title     = {MiR-205 Is Progressively Down-Regulated in Lymph Node Metastasis but Fails as a Prognostic Biomarker in High-Risk Prostate Cancer},
  series = {International Journal of Molecular Sciences},
  journal   = {International Journal of Molecular Sciences},
  doi       = {10.3390/ijms141121414},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-97321},
  year      = {2013},
  abstract  = {The treatment of high-risk prostate cancer (HRPCa) is a tremendous challenge for uro-oncologists. The identification of predictive moleculobiological markers allowing risk assessment of lymph node metastasis and systemic progression is essential in establishing effective treatment. In the current study, we investigate the prognostic potential of miR-205 in HRPCa study and validation cohorts, setting defined clinical endpoints for both. We demonstrate miR-205 to be significantly down-regulated in over 70\% of the HRPCa samples analysed and that reconstitution of miR-205 causes inhibition of proliferation and invasiveness in prostate cancer (PCa) cell lines. Additionally, miR-205 is increasingly down-regulated in lymph node metastases compared to the primary tumour indicating that miR-205 plays a role in migration of PCa cells from the original location into extraprostatic tissue. Nevertheless, down-regulation of miR-205 in primary PCa was not correlated to the synchronous presence of metastasis and failed to predict the outcome for HRPCa patients. Moreover, we found a tendency for miR-205 up-regulation to correlate with an adverse outcome of PCa patients suggesting a pivotal role of miR-205 in tumourigenesis. Overall, we showed that miR-205 is involved in the development and metastasis of PCa, but failed to work as a useful clinical biomarker in HRPCa. These findings might have implications for the use of miR-205 as a prognostic or therapeutic target in HRPCa.},
  language  = {en}
}
@article{WeidemannNiemannStorketal.2013,
  author    = {Weidemann, F. and Niemann, M. and Stork, S. and Breunig, F. and Beer, M. and Sommer, C. and Herrmann, S. and Ertl, G. and Wanner, C.},
  title     = {Long-term outcome of enzyme-replacement therapy in advanced Fabry disease: evidence for disease progression towards serious complications},
  series = {Journal of Internal Medicine},
  volume    = {247},
  journal   = {Journal of Internal Medicine},
  number    = {4},
  doi       = {10.1111/joim.12077},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-132075},
  pages     = {331-4},
  year      = {2013},
  abstract  = {The long-term effects of enzyme-replacement therapy (ERT) in Fabry disease are unknown. Thus, the aim of this study was to determine whether ERT in patients with advanced Fabry disease affects progression towards 'hard' clinical end-points in comparison with the natural course of the disease. METHODS: A total of 40 patients with genetically proven Fabry disease (mean age 40 ± 9 years; n = 9 women) were treated prospectively with ERT for 6 years. In addition, 40 subjects from the Fabry Registry, matched for age, sex, chronic kidney disease stage and previous transient ischaemic attack (TIA), served as a comparison group. The main outcome was a composite of stroke, end-stage renal disease (ESRD) and death. Secondary outcomes included changes in myocardial left ventricular (LV) wall thickness and replacement fibrosis, change in glomerular filtration rate (GFR), new TIA and change in neuropathic pain. RESULTS: During a median follow-up of 6.0 years (bottom and top quartiles: 5.1, 7.2), 15 events occurred in 13 patients (n = 7 deaths, n = 4 cases of ESRD and n = 4 strokes). Sudden death occurred (n = 6) only in patients with documented ventricular tachycardia and myocardial replacement fibrosis. The annual progression of myocardial LV fibrosis in the entire cohort was 0.6 ± 0.7\%. As a result, posterior end-diastolic wall thinning was observed (baseline, 13.2 ± 2.0 mm; follow-up, 11.4 ± 2.1 mm; P < 0.01). GFR decreased by 2.3 ± 4.6 mL min(-1) per year. Three patients experienced a TIA. The major clinical symptom was neuropathic pain (n = 37), and this symptom improved in 25 patients. The event rate was not different between the ERT group and the untreated (natural history) group of the Fabry Registry. CONCLUSION: Despite ERT, clinically meaningful events including sudden cardiac death continue to develop in patients with advanced Fabry disease.},
  language  = {en}
}
@article{TuetuencueOlmaKunzeetal.2022,
  author    = {T{\"u}t{\"u}nc{\"u}, Serdar and Olma, Manuel C. and Kunze, Claudia and Kr{\"a}mer, Michael and Dietzel, Joanna and Schurig, Johannes and Filser, Paula and Pfeilschifter, Waltraud and Hamann, Gerhard F. and B{\"u}ttner, Thomas and Heuschmann, Peter U. and Kirchhof, Paulus and Laufs, Ulrich and Nabavi, Darius G. and R{\"o}ther, Joachim and Thomalla, G{\"o}tz and Veltkamp, Roland and Eckardt, Kai-Uwe and Haeusler, Karl Georg and Endres, Matthias},
  title     = {Levels and dynamics of estimated glomerular filtration rate and recurrent vascular events and death in patients with minor stroke or transient ischemic attack},
  series = {European Journal of Neurology},
  volume    = {29},
  journal   = {European Journal of Neurology},
  number    = {9},
  doi       = {10.1111/ene.15431},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-287271},
  pages     = {2716 -- 2724},
  year      = {2022},
  abstract  = {Background and purpose Impaired kidney function is associated with an increased risk of vascular events in acute stroke patients, when assessed by single measurements of estimated glomerular filtration rate (eGFR). It is unknown whether repeated measurements provide additional information for risk prediction. Methods The MonDAFIS (Systematic Monitoring for Detection of Atrial Fibrillation in Patients with Acute Ischemic Stroke) study randomly assigned 3465 acute ischemic stroke patients to either standard procedures or an additive Holter electrocardiogram. Baseline eGFR (CKD-EPI formula) were dichotomized into values of < versus ≥60 ml/min/1.73 m\(^{2}\). eGFR dynamics were classified based on two in-hospital values as "stable normal" (≥60 ml/min/1.73 m\(^{2}\)), "increasing" (by at least 15\% from baseline, second value ≥ 60 ml/min/1.73 m\(^{2}\)), "decreasing" (by at least 15\% from baseline of ≥60 ml/min/1.73 m\(^{2}\)), and "stable decreased" (<60 ml/min/1.73 m\(^{2}\)). The composite endpoint (stroke, major bleeding, myocardial infarction, all-cause death) was assessed after 24 months. We estimated hazard ratios in confounder-adjusted models. Results Estimated glomerular filtration rate at baseline was available in 2947 and a second value in 1623 patients. After adjusting for age, stroke severity, cardiovascular risk factors, and randomization, eGFR < 60 ml/min/1.73 m\(^{2}\) at baseline (hazard ratio [HR] = 2.2, 95\% confidence interval [CI] = 1.40-3.54) as well as decreasing (HR = 1.79, 95\% CI = 1.07-2.99) and stable decreased eGFR (HR = 1.64, 95\% CI = 1.20-2.24) were independently associated with the composite endpoint. In addition, eGFR < 60 ml/min/1.732 at baseline (HR = 3.02, 95\% CI = 1.51-6.10) and decreasing eGFR were associated with all-cause death (HR = 3.12, 95\% CI = 1.63-5.98). Conclusions In addition to patients with low eGFR levels at baseline, also those with decreasing eGFR have increased risk for vascular events and death; hence, repeated estimates of eGFR might add relevant information to risk prediction.},
  language  = {en}
}
@article{ChifuHeinzeFussetal.2020,
  author    = {Chifu, Irina and Heinze, Britta and Fuss, Carmina T. and Lang, Katharina and Kroiss, Matthias and Kircher, Stefan and Ronchi, Cristina L. and Altieri, Barbara and Schirbel, Andreas and Fassnacht, Martin and Hahner, Stefanie},
  title     = {Impact of the Chemokine Receptors CXCR4 and CXCR7 on Clinical Outcome in Adrenocortical Carcinoma},
  series = {Frontiers in Endocrinology},
  volume    = {11},
  journal   = {Frontiers in Endocrinology},
  issn      = {1664-2392},
  doi       = {10.3389/fendo.2020.597878},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-216494},
  year      = {2020},
  abstract  = {Chemokine receptors have a negative impact on tumor progression in several human cancers and have therefore been of interest for molecular imaging and targeted therapy. However, their clinical and prognostic significance in adrenocortical carcinoma (ACC) is unknown. The aim of this study was to evaluate the chemokine receptor profile in ACC and to analyse its association with clinicopathological characteristics and clinical outcome. A chemokine receptor profile was initially evaluated by quantitative PCR in 4 normal adrenals, 18 ACC samples and human ACC cell line NCI-H295. High expression of CXCR4 and CXCR7 in both healthy and malignant adrenal tissue and ACC cells was confirmed. In the next step, we analyzed the expression and cellular localization of CXCR4 and CXCR7 in ACC by immunohistochemistry in 187 and 84 samples, respectively. These results were correlated with clinicopathological parameters and survival outcome. We detected strong membrane expression of CXCR4 and CXCR7 in 50\% of ACC samples. Strong cytoplasmic CXCR4 staining was more frequent among samples derived from metastases compared to primaries (p=0.01) and local recurrences (p=0.04). CXCR4 membrane staining positively correlated with proliferation index Ki67 (r=0.17, p=0.028). CXCR7 membrane staining negatively correlated with Ki67 (r=-0.254, p=0.03) but positively with tumor size (r=0.3, p=0.02). No differences in progression-free or overall survival were observed between patients with strong and weak staining intensities for CXCR4 or CXCR7. Taken together, high expression of CXCR4 and CXCR7 in both local tumors and metastases suggests that some ACC patients might benefit from CXCR4/CXCR7-targeted therapy.},
  language  = {en}
}
@article{LiuHuNiemannetal.2013,
  author    = {Liu, Dan and Hu, Kai and Niemann, Markus and Herrmann, Sebastian and Cikes, Maja and St{\"o}rk, Stefan and Beer, Meinrad and Gaudron, Philipp Daniel and Morbach, Caroline and Knop, Stefan and Geissinger, Eva and Ertl, Georg and Bijnens, Bart and Weidemann, Frank},
  title     = {Impact of Regional Left Ventricular Function on Outcome for Patients with AL Amyloidosis},
  series = {PLoS ONE},
  volume    = {8},
  journal   = {PLoS ONE},
  number    = {3},
  doi       = {10.1371/journal.pone.0056923},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-130293},
  pages     = {e56923},
  year      = {2013},
  abstract  = {Objectives The aim of this study was to explore the left ventricular (LV) deformation changes and the potential impact of deformation on outcome in patients with proven light-chain (AL) amyloidosis and LV hypertrophy. Background Cardiac involvement in AL amyloidosis patients is associated with poor outcome. Detecting regional cardiac function by advanced non-invasive techniques might be favorable for predicting outcome. Methods LV longitudinal, circumferential and radial peak systolic strains (Ssys) were assessed by speckle tracking imaging (STI) in 44 biopsy-proven systemic AL amyloidosis patients with LV hypertrophy (CA) and in 30 normal controls. Patients were divided into compensated (n = 18) and decompensated (n = 26) group based on clinical assessment and followed-up for a median period of 345 days. Results Ejection fraction (EF) was preserved while longitudinal Ssys (LSsys) was significantly reduced in both compensated and decompensated groups. Survival was significantly reduced in decompensated group (35\% vs. compensated 78\%, P = 0.001). LSsys were similar in apical segments and significantly reduced in basal segments between two patient groups. LSsys at mid-segments were significantly reduced in all LV walls of decompensated group. Patients were further divided into 4 subgroups according to the presence or absence of reduced LSsys in no (normal), only basal (mild), basal and mid (intermediate) and all segments of the septum (severe). This staging revealed continuously worse prognosis in proportion to increasing number of segments with reduced LSsys (mortality: normal 14\%, mild 27\%, intermediate 67\%, and severe 64\%). Mid-septum LSsys<11\% suggested a 4.8-fold mortality risk than mid-septum LSsys≥11\%. Multivariate regression analysis showed NYHA class and mid-septum LSsys were independent predictors for survival. Conclusions Reduced deformation at mid-septum is associated with worse prognosis in systemic amyloidosis patients with LV hypertrophy.},
  language  = {en}
}
@article{MorisVandenBroeckToscoetal.2016,
  author    = {Moris, Lisa and Van den Broeck, Thomas and Tosco, Lorenzo and Van Baelen, Anthony and Gontero, Paolo and Karnes, Robert Jeffrey and Everaerts, Wouter and Albersen, Maarten and Bastian, Patrick J. and Chlosta, Piotr and Claessens, Frank and Chun, Felix K. and Graefen, Markus and Gratzke, Christian and Kneitz, Burkhard and Marchioro, Giansilvio and Salas, Rafael Sanchez and Tombal, Bertrand and Van Der Poel, Henk and Walz, Jochen Christoph and De Meerleer, Gert and Bossi, Alberto and Haustermans, Karin and Montorsi, Francesco and Van Poppel, Hendrik and Spahn, Martin and Briganti, Alberto and Joniau, Steven},
  title     = {Impact of lymph node burden on survival of high-risk prostate cancer patients following radical prostatectomy and pelvic lymph node dissection},
  series = {Frontiers in Surgery},
  volume    = {3},
  journal   = {Frontiers in Surgery},
  organization    = {European Multicenter Prostate Cancer Clinical and Translational Research Group (EMPaCT)},
  issn      = {2296-875X},
  doi       = {10.3389/fsurg.2016.00065},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-195721},
  year      = {2016},
  abstract  = {Aim To determine the impact of the extent of lymph node invasion (LNI) on long-term oncological outcomes after radical prostatectomy (RP). Material and methods In this retrospective study, we examined the data of 1,249 high-risk, non-metastatic PCa patients treated with RP and pelvic lymph node dissection (PLND) between 1989 and 2011 at eight different tertiary institutions. We fitted univariate and multivariate Cox models to assess independent predictors of cancer-specific survival (CSS) and overall survival (OS). The number of positive lymph node (LN) was dichotomized according to the most informative cutoff predicting CSS. Kaplan-Meier curves assessed CSS and OS rates. Only patients with at least 10 LNs removed at PLND were included. This cutoff was chosen as a surrogate for a well performed PNLD. Results Mean age was 65 years (median: 66, IQR 60-70). Positive surgical margins were present in 53.7\% (n = 671). Final Gleason score (GS) was 2-6 in 12.7\% (n = 158), 7 in 52\% (n = 649), and 8-10 in 35.4\% (n = 442). The median number of LNs removed during PLND was 15 (IQR 12-17). Of all patients, 1,128 (90.3\%) had 0-3 positive LNs, while 126 (9.7\%) had ≥4 positive LNs. Patients with 0-3 positive LNs had significantly better CSS outcome at 10-year follow-up compared to patients with ≥4 positive LNs (87 vs. 50\%; p < 0.0001). Similar results were obtained for OS, with a 72 vs. 37\% (p < 0.0001) survival at 10 years for patients with 0-3 vs. ≥4 positive LNs, respectively. At multivariate analysis, final GS of 8-10, salvage ADT therapy, and ≥4 (vs. <4) positive LNs were predictors of worse CSS and OS. Pathological stage pT4 was an additional predictor of worse CSS. Conclusion Four or more positive LNs, pathological stage pT4, and final GS of 8-10 represent independent predictors for worse CSS in patients with high-risk PCa. Primary tumor biology remains a strong driver of tumor progression and patients having ≥4 positive LNs could be considered an enriched patient group in which novel treatment strategies should be studied.},
  language  = {en}
}