Papers by Franziska Geissler
829 Understanding BRCA1-Methylation stability to improve PARP inhibitor responses in high-grade serous ovarian carcinomas
Intracorporeal vs. extracorporeal open and closed knot tying techniques in laparoscopy: A randomized, controlled study
Heliyon, Feb 1, 2024
The role of aberrant DNA methylation in cancer initiation and clinical impacts
Therapeutic advances in medical oncology, 2024
World Journal of Surgical Oncology, Feb 9, 2023
Introduction Contralateral axillary lymph node metastasis (CALNM) in breast cancer (BC) is consid... more Introduction Contralateral axillary lymph node metastasis (CALNM) in breast cancer (BC) is considered a distant metastasis, marking stage 4cancer. Therefore, it is generally treated as an incurable disease. However, in clinical practice, staging and treatment remain controversial due to a paucity of data, and the St. Gallen 2021 consensus panel recommended a curative approach in patients with oligometastatic disease. Aberrant lymph node (LN) drainage following previous surgery or radiotherapy is common. Therefore, CALNM may be considered a regional event rather than systemic disease, and a re-sentinel procedure aided by lymphoscintigraphy permits adequate regional staging. Case report Here, we report a 37-year-old patient with Lynch syndrome who presented with CALNM in an ipsilateral relapse of a moderately differentiated invasive ductal BC (ER 90%, PR 30%, HER2 negative, Ki-67 25%, microsatellite stable), 3 years after the initial diagnosis. Lymphoscintigraphy detected a positive sentinel LN in the contralateral axilla despite no sign of LN involvement or distant metastases on FDG PET/CT or MRI. The patient underwent bilateral mastectomy with sentinel node dissection, surgical reconstruction with histological confirmation of the CALNM, left axillary dissection, adjuvant chemotherapy, and anti-hormone therapy. In addition to her regular BC follow-up visits, the patient will undergo annual colonoscopy, gastroscopy, abdominal, and vaginal ultrasound screening. In January 2023, the patient was free of progression for 23 months after initiation of treatment for recurrent BC and CALNM. Conclusion This case highlights the value of delayed lymphoscintigraphy and the contribution of sentinel procedure for local control in the setting of recurrent BC. Aberrant lymph node drainage following previous surgery may be the underlying cause of CALNM. We propose that CALNM without evidence of systemic metastasis should be considered a regional event in recurrent BC, and thus, a curative approach can be pursued. The next AJCC BC staging should clarify the role of CALNM in recurrent BC to allow for the development of specific treatment guidelines.
World Journal of Surgical Oncology, Feb 9, 2023
Introduction Contralateral axillary lymph node metastasis (CALNM) in breast cancer (BC) is consid... more Introduction Contralateral axillary lymph node metastasis (CALNM) in breast cancer (BC) is considered a distant metastasis, marking stage 4cancer. Therefore, it is generally treated as an incurable disease. However, in clinical practice, staging and treatment remain controversial due to a paucity of data, and the St. Gallen 2021 consensus panel recommended a curative approach in patients with oligometastatic disease. Aberrant lymph node (LN) drainage following previous surgery or radiotherapy is common. Therefore, CALNM may be considered a regional event rather than systemic disease, and a re-sentinel procedure aided by lymphoscintigraphy permits adequate regional staging. Case report Here, we report a 37-year-old patient with Lynch syndrome who presented with CALNM in an ipsilateral relapse of a moderately differentiated invasive ductal BC (ER 90%, PR 30%, HER2 negative, Ki-67 25%, microsatellite stable), 3 years after the initial diagnosis. Lymphoscintigraphy detected a positive sentinel LN in the contralateral axilla despite no sign of LN involvement or distant metastases on FDG PET/CT or MRI. The patient underwent bilateral mastectomy with sentinel node dissection, surgical reconstruction with histological confirmation of the CALNM, left axillary dissection, adjuvant chemotherapy, and anti-hormone therapy. In addition to her regular BC follow-up visits, the patient will undergo annual colonoscopy, gastroscopy, abdominal, and vaginal ultrasound screening. In January 2023, the patient was free of progression for 23 months after initiation of treatment for recurrent BC and CALNM. Conclusion This case highlights the value of delayed lymphoscintigraphy and the contribution of sentinel procedure for local control in the setting of recurrent BC. Aberrant lymph node drainage following previous surgery may be the underlying cause of CALNM. We propose that CALNM without evidence of systemic metastasis should be considered a regional event in recurrent BC, and thus, a curative approach can be pursued. The next AJCC BC staging should clarify the role of CALNM in recurrent BC to allow for the development of specific treatment guidelines.
Adherence to multidisciplinary team meeting recommendations in elderly patients with HER2-positive breast cancer
Purpose Applying current treatment guidelines to elderly breast cancer (BC) patients is challenge... more Purpose Applying current treatment guidelines to elderly breast cancer (BC) patients is challenged by limited trial guidance, higher toxicities, and non-cancer related mortality. This study investigated adherence to multidisciplinary team meeting (MDTM) recommendations in elderly women with HER2 positive BC (HER2+BC) and its impacts on patient survival. Methods This retrospective multicentre cohort study collected data from 305 patients with primary diagnosis of HER2+BC. Women aged ≥65 years were classified into “concordant” or “discordant” groups according to MDTM recommendation adherence. Cox proportional hazards models and logistic regression analysis were used to assess the association between prognostic factors and patient outcomes. Results Of 305 HER2+BC patients, 111 (36%) were ≥65 years old. Of these, 55 (49.5%) and 53 (47.7%) were assigned to the concordant or discordant groups, respectively. The most frequent cause of MDTM discordance was treatment rejection by patients (5...
BRCA1 secondary splice-site mutations drive exon-skipping and PARP inhibitor resistance
medRxiv (Cold Spring Harbor Laboratory), Mar 21, 2023
Research Square (Research Square), Dec 15, 2022
Background: The gami cation of laparoscopy using physical computing is an attempt to incentivize ... more Background: The gami cation of laparoscopy using physical computing is an attempt to incentivize training and generate data for analysis. Here, we evaluate a laparoscopic dexterity game box (LDGB) in a pelvitrainer model for laparoscopic training by comparing the performance of the validated Laparoscopic Skills Training and Testing 3 (LASTT 3) exercise from the Gynaecological Endoscopic Surgical Education and Assessment (GESEA) program. Methods: Sixty medical students with no experience in laparoscopy were randomized into three groups with 20 participants in each. All three groups performed four runs of the validated LASTT 3 exercise. Group A completed 40 runs with the LDGB, Group B completed 20 runs, and Group C completed no runs. Task completion time and the number of errors made were recorded. The Wilcoxon test and mixed-effects models were used to analyze the results. After completing the exercises, participants answered questions concerning the LDGB and their performance. Results: The students improved their performance after using the LDGB. They were signi cantly faster at performing the LASTT 3 exercise using the LDGB, with a mean difference of 40s (P=0.013) between Group A (185s) and Group C (225s), and 26s (P=0.105) between Group B (199s) and Group C (225s). There were no signi cant differences between the mistakes made. The students were signi cantly faster (P<0.001) in completing the LDGB exercise during a second repetition, with fewer mistakes made (P<0.001). The LDGB was rated as intuitive by 86.4% of the participants. Conclusions: Students using the LDGB achieved better results in the GESEA exercise. These bene ts were accompanied by subjective advantages noted by the students. Gami cation presents an opportunity to improve laparoscopic performance. Background Laparoscopic surgery is a well-established procedure used in different surgical elds that replaces more invasive open surgery by demonstrating clear bene ts over open surgery. In particular, laparoscopic surgery has advantages such as a reduction of blood loss, a signi cant decline in the postoperative infection rate, shorter hospitalization times, and faster recoveries. 1-3 However, there are some disadvantages such as technical limitations, limited degrees of freedom, unnatural ergonomics, limitations in current laparoscopic instrument design, limited vision, and a dependency on the skills and training of surgeons, 4,5 These challenges result in a slower learning curve with more operations needed before reaching an expert level. 6,7 8 Approaches to overcoming technical limitations have been developed by improving instrument ergonomics, adding more degrees of freedom, using exible endoscopes, 9,10 or improving vision by using 3-dimensional (3D) imaging systems. 11,12 However, dependency on the skills and training of surgeons can only be mastered with adequate training. For laparoscopy, different skills must be trained such as hand-eye coordination, the use of non-and dominant hands, and compensation for depth perception loss due to
Contralateral lymph node metastasis in recurrent ipsilateral breast cancer with Lynch syndrome: a locoregional event
Introduction Contralateral axillary lymph node metastasis (CALNM) in breast cancer (BC) is consid... more Introduction Contralateral axillary lymph node metastasis (CALNM) in breast cancer (BC) is considered a distant metastasis, marking stage IV cancer. Therefore, it is generally treated as an incurable disease. However, in clinical practice, staging and treatment remain controversial due to a paucity of data, and the St. Gallen 2021 consensus panel recommended a curative approach in patients with oligometastatic disease. Aberrant lymph node (LN) drainage following previous surgery or radiotherapy is common. Therefore, CALNM may be considered a regional event rather than systemic disease, and a re-sentinel procedure aided by lymphoscintigraphy permits adequate regional staging.Case report: Here, we report a 37-year-old patient with Lynch syndrome who presented with CALNM in an ipsilateral relapse of a moderately-differentiated invasive ductal BC (ER 90%, PR 30%, HER2 negative, Ki-67 25 %, microsatellite stable), three years after the initial diagnosis. Lymphoscintigraphy detected a pos...
Frontiers in Endocrinology
BackgroundWe aim to evaluate the impact of prepregnancy overweight on treatment modalities of Ges... more BackgroundWe aim to evaluate the impact of prepregnancy overweight on treatment modalities of Gestational Diabetes Mellitus (GDM). We assessed the association of increased pregravid Body Mass Index (BMI) with dosing of basal and rapid acting insulin as well as pregnancy outcome.MethodsWe included 509 gestational diabetic women (normal weight: 200, overweight: 157, obese: 152), attending the pregnancy outpatient clinic at the Department of Obstetrics and Gynecology, Medical University of Vienna, in this retrospective study. We used a prospectively compiled database to assess patient characteristics, treatment approaches – particularly maximum doses of basal and rapid acting insulin or metformin – and pregnancy outcome.ResultsIncreased BMI was associated with the need of glucose lowering medication (odds ratio (OR): 1.08 for the increase of 1 kg/m² BMI, 95%CI 1.05–1.11, p<0.001). Mothers with pregestational obesity received the highest amount of insulin. Metformin was more often us...
BMJ Case Reports, 2021
Pituitary apoplexy is caused by haemorrhage or infarction of the pituitary gland. Presenting sign... more Pituitary apoplexy is caused by haemorrhage or infarction of the pituitary gland. Presenting signs and symptoms often include severe headache, visual disturbance, ophthalmoplegia, altered consciousness and impaired pituitary function. The management of pituitary apoplexy has very rarely been described during pregnancy and there is no existing data for further pregnancies of affected women. We present a case of a woman with a recurrent pituitary apoplexy due to haemorrhages in a pituitary adenoma in her third and fourth pregnancies. In both pregnancies, the pituitary apoplexy was managed conservatively, but due to therapy-resistant headaches, a preterm delivery was implemented.
European Journal of Clinical Investigation, 2021
This is an open access article under the terms of the Creative Commons Attribution License, which... more This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
BMJ Open, 2020
PurposeThe pregnancy cohort was established to examine the prevalence and variety of haemoglobino... more PurposeThe pregnancy cohort was established to examine the prevalence and variety of haemoglobinopathies in a high-risk group of pregnant women.ParticipantsThe pregnancy cohort is located in the Department of Obstetrics and Antenatal Care, University Hospital of Basel. The pregnant women were recruited in the first trimester between June 2015 and May 2019. Family origin questionnaires were used to screen pregnant women for the risk of a haemoglobin variant. Based on the questionnaire, pregnant women were divided into two groups: women with a high risk and women with a low risk of a haemoglobin variant. In women with a high risk, red blood cell indices, iron status and chromatography were conducted.Findings to date1785 pregnant women were recruited. Out of the 1785 women, 929 were identified as a part of the high-risk group. Due to the missing data of 74 pregnant women with a high risk, the final analysis was conducted in the remaining 855 women. The prevalence of haemoglobinopathies...
Endocrine connections, 2012
Insulin-like growth factor 2 (IGF2) is the predominant IGF in adults and regulates cell growth. I... more Insulin-like growth factor 2 (IGF2) is the predominant IGF in adults and regulates cell growth. In contrast to normal tissues, where IGF2 is imprinted and only expressed from the paternal allele, loss of imprinting (LOI) and biallelic IGF2 expression are observed in many cancers including prostate cancer (PCa). We here studied whether LOI of IGF2 in normal circulating peripheral blood lymphocytes can predict increased PCa risk. We analyzed IGF2 protein levels, IGF2 820G/A genotype and imprinting status, as well as methylation status of the IGF2 imprinting control region (ICR) in 113 blood samples of patients with a history of radical prostatectomy (RPE) for PCa by ELISA, restriction-fragment length polymorphism, and bisulfite-DNA sequencing. Results were compared to 249 male blood donors with unknown prostate specific antigen (PSA) status. The 820G/A genotype was enriched in the RPE group and was associated with younger age at cancer diagnosis. LOI in patients was only slightly more...
Low grade serous ovarian cancer – A rare disease with increasing therapeutic options
Cancer Treatment Reviews
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Papers by Franziska Geissler