TY  - JOUR
A1  - Wiegering, Armin
A1  - Riegel, Johannes
A1  - Wagner, Johanna
A1  - Kunzmann, Volker
A1  - Baur, Johannes
A1  - Walles, Thorsten
A1  - Dietz, Ulrich
A1  - Loeb, Stefan
A1  - Germer, Christoph-Thomas
A1  - Steger, Ulrich
A1  - Klein, Ingo
T1  - The impact of pulmonary metastasectomy in patients with previously resected colorectal cancer liver metastases
JF  - PLoS ONE
N2  - Background
40–50% of patients with colorectal cancer (CRC) will develop liver metastases (CRLM) during the course of the disease. One third of these patients will additionally develop pulmonary metastases.

Methods
137 consecutive patients with CRLM, were analyzed regarding survival data, clinical, histological data and treatment. Results were stratified according to the occurrence of pulmonary metastases and metastases resection.

Results
39% of all patients with liver resection due to CRLM developed additional lung metastases. 44% of these patients underwent subsequent pulmonary resection. Patients undergoing pulmonary metastasectomy showed a significantly better five-year survival compared to patients not qualified for curative resection (5-year survival 71.2% vs. 28.0%; p = 0.001). Interestingly, the 5-year survival of these patients was even superior to all patients with CRLM, who did not develop pulmonary metastases (77.5% vs. 63.5%; p = 0.015). Patients, whose pulmonary metastases were not resected, were more likely to redevelop liver metastases (50.0% vs 78.6%; p = 0.034). However, the rate of distant metastases did not differ between both groups (54.5 vs.53.6; p = 0.945).

Conclusion
The occurrence of colorectal lung metastases after curative liver resection does not impact patient survival if pulmonary metastasectomy is feasible. Those patients clearly benefit from repeated resections of the liver and the lung metastases.
KW  - hepatic resection
KW  - surgical resection
KW  - lung resection
KW  - curative resection
KW  - metastasis
KW  - colorectal cancer
KW  - cancer treatment
KW  - surgical oncology
Y1  - 2017
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-158036
VL  - 12
IS  - 3
ER  - 
TY  - JOUR
A1  - Busch, Albert
A1  - Hoffjan, Sabine
A1  - Bergmann, Frauke
A1  - Hartung, Birgit
A1  - Jung, Helena
A1  - Hanel, Daniela
A1  - Tzschach, Andeas
A1  - Kadar, Janos
A1  - von Kodolitsch, Yskert
A1  - Germer, Christoph-Thomas
A1  - Trobisch, Heiner
A1  - Strasser, Erwin
A1  - Wildenauer, René
T1  - Vascular type Ehlers-Danlos syndrome is associated with platelet dysfunction and low vitamin D serum concentration
JF  - Orphanet Journal of Rare Diseases
N2  - Background

The vascular type represents a very rare, yet the clinically most fatal entity of Ehlers-Danlos syndrome (EDS). Patients are often admitted due to arterial bleedings and the friable tissue and the altered coagulation contribute to the challenge in treatment strategies. Until now there is little information about clotting characteristics that might influence hemostasis decisively and eventually worsen emergency situations.

Results

22 vascular type EDS patients were studied for hemoglobin, platelet volume and count, Quick and activated partial thromboplastin time, fibrinogen, factor XIII, von Willebrand disease, vitamin D and platelet aggregation by modern standard laboratory methods. Results show a high prevalence of over 50 % for platelet aggregation disorders in vascular type EDS patients, especially for collagen and epinephrine induced tests, whereas the plasmatic cascade did not show any alterations. Additionally, more than half of the tested subjects showed low vitamin D serum levels, which might additionally affect vascular wall integrity.

Conclusion

The presented data underline the importance of detailed laboratory screening methods in vascular type EDS patients in order to allow for targeted application of platelet-interacting substances that might be of decisive benefit in the emergency setting.
KW  - vascular type
KW  - vitamin D
KW  - Ehlers-Danlos syndrome
KW  - EDS
KW  - platelet dysfunction
Y1  - 2016
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-147757
VL  - 11
IS  - 111
ER  -