Fabian Riedel - Academia.edu (original) (raw)

Papers by Fabian Riedel

Research paper thumbnail of Axilläres operatives Management bei befallenen Sentinel-Lymphknoten in einer deutschlandweiten Mammakarzinom-Kohorte

Information und Programm: www.senologiekongress.de, May 1, 2018

Research paper thumbnail of Exploring the current state of medical education in obstetrics and gynecology: A nationwide survey among German teaching coordinators

Research Square (Research Square), May 12, 2023

Background: Obstetrics and gynecology (OB/GYN) is an essential medical eld that focuses on women'... more Background: Obstetrics and gynecology (OB/GYN) is an essential medical eld that focuses on women's health. Universities aim to provide highquality healthcare services to women through comprehensive education of medical students. The objective of the present survey was both to ascertain perspectives on the teaching methods, resources, and challenges faced by medical educators in the eld of OB/GYN in Germany and to identify possible room from improvement. The survey was conducted with teaching coordinators from most German university OB/GYN departments. Methods: A questionnaire was sent to the teaching coordinators in all 41 OB/GYN departments at German university hospitals. The survey was delivered via email with a link to an online survey platform. Results: The study received 30 responses from 41 universities. In addition to standard teaching formats, such as lectures, seminars, and clinical clerkships, the universities differed in their additional teaching offerings. Gynecological history-taking and general gynecology had the highest rates of learning success, while sub elds such as reproductive medicine and urogynecology performed poorly. E-learning was found to be widely used and was considered advantageous. While good teaching was found to be essential and valued by students, a shortage of resources for medical education was noted. Conclusion: The present study provides valuable insights into the current state of medical education in OB/GYN at German universities from the perspective of teaching experts. We discuss approaches to overcoming current obstacles and offer suggestions for improvement. Background Obstetrics and gynecology (OB/GYN) is an essential medical eld that focuses on women's health. Providing medical students with comprehensive and up-to-date education in this area is vital to ensuring the delivery of high-quality healthcare services to women. In the German medical education system, only university hospitals and their a liated teaching hospitals are authorized to provide medical teaching, examinations, and licensing. Teaching coordinators-who hold an o cial position within a department (such as OB/GYN)-are appointed by the medical faculty and are usually senior physicians who work part-time in this role. Typically, one person with expertise and experience in medical teaching is responsible for the position in each medical department. Teaching coordinators are responsible for organizing and supervising all theoretical and practical student courses. They also develop the curriculum and implement innovative teaching formats within their respective departments. Moreover, along with other teaching coordinators from various departments, these coordinators often serve as members of the central decision-making body when it comes to coordinating medical teaching. Teaching coordinators usually also participate in teaching during lectures, seminars, and hands-on courses together with the teaching staff (1). Medical studies in Germany are divided into three phases and typically take six years in total to complete. The initial two pre-clinical years focus on fundamental sciences, such as biology, physics, anatomy, physiology, and (bio-)chemistry, and are followed by three years of comprehensive clinical education. The clinical curriculum encompasses all major and minor specialties, which are taught through lectures, seminars, and bedside teaching (2). The nal year-called the "Praktisches Jahr" (PJ)-involves full-time training in usually three 16-week blocks that consist of internal medicine, (general) surgery, and an elective specialty. The nal year allows students to gain hands-on experience in different medical settings, such as hospitals, clinics, and other healthcare facilities (3). As medical knowledge and practices constantly evolve, it is critical to regularly assess the status of medical education in OB/GYN and to identify any gaps or areas that require improvement. To that end, in cooperation with the Young Forum of the German Society for Gynecology and Obstetrics (i.e., the German interest group and organization of young physicians in training in OB/GYN), we conducted a nationwide survey among German teaching coordinators with the goal of exploring the current state of medical education in OB/GYN (4). The goal of the survey was to gather insights into the teaching methods, resources, and challenges faced

Research paper thumbnail of Diagnostic accuracy and clinical utility of axillary ultrasound in the evaluation of axillary lymph node status in early breast cancer patients

Geburtshilfe Und Frauenheilkunde, Oct 1, 2020

Research paper thumbnail of Veränderung des axillären Managements bei Brustkrebspatientinnen mit 1 – 2 tumorbefallenen Sentinel-Lymphknoten

Geburtshilfe Und Frauenheilkunde, Sep 20, 2018

Research paper thumbnail of Evaluation des Nutzens von intraoperativer Präparateradiografie zur Randbeurteilung bei brusterhaltender Therapie maligner Brusttumore

Geburtshilfe Und Frauenheilkunde, Sep 20, 2018

Research paper thumbnail of Oncologic outcomes for different axillary staging techniques in nodal positive breast cancer undergoing neoadjuvant systematic treatment: A cancer registry study

Journal of Clinical Oncology, Jun 1, 2023

e12571 Background: The optimal axillary staging technique for patients with nodal positive breast... more e12571 Background: The optimal axillary staging technique for patients with nodal positive breast cancer undergoing neoadjuvant systemic treatment (NAST) is unclear. Less invasive, targeted approaches like targeted axillary dissection (TAD) or sentinel-lymph node biopsy (SLNB) recently showed false-negative rates < 10% compared to axillary lymph node dissection (ALND). Oncologic outcomes, however, are unknown. Methods: We identified nodal positive breast cancer patients undergoing NAST from 2016 to 2021 with at least 1-year follow-up and available information regarding axillary staging from the state cancer registry of Baden-Wuerttemberg, Germany. Invasive disease-free survival (iDFS) was assessed using Kaplan-Meier statistics and multivariate cox regression models (adjusted for age, pN stage, pT stage, and tumor biologic subtype). Results: A total of 2403 patients with a median follow-up of 23.2-months after surgery were identified: 1963 underwent ALND, 407 underwent SLNB (in 230 cases, three or more sentinel nodes (SLNs) were removed and in 177 cases, 1-2 SLNs were removed), and 33 underwent TAD. The proportion of patients with pN+ stage within these four groups was 54%, 31%, 26%, and 35%, respectively ( P < 0.001). Significant differences in iDFS between the ALND, SLNB, and TAD groups were observed (log rank P = 0.046): iDFS 2 years after surgery was 74.5% (ALND), 80.2% (SLNB ≥3 removed SLNs), 85.6% (SLNB < 3 removed SLNs), and 88.4% (TAD), respectively. iDFS after 4 years was 61.5% (ALND), 69.1% (SLNB ≥3 removed SLNs), and 74.6% (SLNB < 3 removed SLNs), respectively. Multivariate cox regression analysis showed no significant influence of different axillary staging techniques on iDFS: HR 0.91 (95% CI 0.55 to 1.52) for SLNB with ≥3 removed SLNs, HR 0.99 (95% CI 0.59 to 1.67) for SLNB with < 3 removed SLNs (reference = ALND). Conclusions: This data suggests that ALND provides no benefit in terms of iDFS compared to targeted approaches like TAD or SLNB for patients with nodal positive breast cancer undergoing NAST. Future studies with longer-term follow-up are welcomed to fully inform this discussion.

Research paper thumbnail of The COVID-19 pandemic and its impact on medical teaching in obstetrics and gynecology – A nationwide expert survey among teaching coordinators at German university hospitals

Geburtshilfe Und Frauenheilkunde, Oct 1, 2022

Research paper thumbnail of Changes of breast and axillary surgery patterns in patients with primary breast cancer during the past decade

Archives of Gynecology and Obstetrics, Nov 26, 2018

Purpose Breast-conserving therapy (BCT) is the standard procedure for most patients with primary ... more Purpose Breast-conserving therapy (BCT) is the standard procedure for most patients with primary breast cancer (BC). By contrast, axillary management is still under transition to find the right balance between avoiding of morbidity, maintaining oncological safety, and performing a staging procedure. The rising rate of primary systemic therapy creates further challenges for surgical management. Methods Patients with primary, non-metastatic BC treated between 01.01.2003 and 31.12.2016 under guideline-adherent conditions were included in this study. For this prospectively followed cohort, breast and axillary surgery patterns are presented in a time-trend analysis as annual rate data (%) for several subgroups. Results Overall, 6700 patients were included in the analysis. While BCT rates remained high (mean 2003-2016: 70.4%), the proportion of axillary lymph node dissection has declined considerably from 80.1% in 2003 to 16.0% in 2016, while the proportion for sentinel lymph node biopsy (SLND) has increased correspondingly from 10.3 to 76.4%. Among patients with cT1-2, cN0 breast cancer receiving BCT with positive SLND, the rate of axillary completion has decreased from 100% in 2008 to 24.4% in 2016. Conclusions In the past decade, SLNB has been established as the standard procedure for axillary staging of clinically node-negative patients. Surgical morbidity has been further reduced by the rapid implementation of new evidence from the ACOSOG Z0011 trial into clinical routine. The results reflect the transition towards more individually tailored, less invasive treatment for selected patient subgroups, especially in regards to axillary lymph node management.

Research paper thumbnail of Präparateradiographie im Rahmen der brusterhaltender Therapie: Ein nützliches Instrument zur intraoperativen Randbeurteilung, auch nach neoadjuvanter Chemotherapie?

Research paper thumbnail of Erratum: PJ – EPAs und die Frauenheilkunde – Evaluation des Ist- und Soll-Zustands und dessen Diskrepanz

Geburtshilfe Und Frauenheilkunde, Oct 1, 2022

Research paper thumbnail of Can the organic coating of breast tissue markers be sampled by an ultrasound-guided vacuum-assisted biopsy? A comparative proof of concept evaluation of two coated clip marker types in turkey breasts

Geburtshilfe Und Frauenheilkunde, Oct 1, 2022

Research paper thumbnail of Can the organic coating of breast tissue markers be sampled by an ultrasound guided core-cut-biopsy? A comparative proof of concept evaluation of two coated clip marker types in turkey breasts

Research paper thumbnail of Breast biopsy management in patients under anticoagulation or antiplatelet therapy – results from a German Expert Survey

Research paper thumbnail of Die Bedeutung multimodaler Bildgebung und klinischer Informationen für Menschen und KI-basierte Algorithmen bei der Klassifikation von Brustläsionen (INSPiRED 003): eine internationale, multizentrische Analyse

Research paper thumbnail of Veränderungen in der Anwendung und beim Outcome von Chemotherapie beim frühen Mammakarzinom in der letzten Dekade

Geburtshilfe Und Frauenheilkunde, Aug 1, 2017

Research paper thumbnail of Evaluation von Shear-Wave-Elastographie als additives Tool zum Assessment axillärer Lymphknoten in der klinischen Routine

Wissenschaftliche Abstracts zur 40. Jahrestagung der Deutschen Gesellschaft für Senologie e.V. (DGS) Interdisziplinär. Kommunikativ. Digital, Jun 1, 2021

Research paper thumbnail of Does music genre affect medical students’ performance in standardized laparoscopic exercises? Comparing exposure to rock, hip-hop, classic and mixed radio music at 70 decibels

Geburtshilfe Und Frauenheilkunde, Oct 1, 2020

Research paper thumbnail of Veränderung des axillären Management nach Mastektomie bei Patientinnen mit tumorbefallenem Sentinel-Lymphknoten

Research paper thumbnail of Klaus-Dieter-Schulz-Versorgungsforschungspreis - Veränderungen in der Anwendung und beim Outcome von Chemotherapie beim frühen Mammakarzinom in der letzten Dekade (2003–2014)

Research paper thumbnail of Veränderungen in der Anwendung und beim Outcome von Chemotherapie beim frühen Mammakarzinom in der letzten Dekade (2003 – 2014)

Research paper thumbnail of Axilläres operatives Management bei befallenen Sentinel-Lymphknoten in einer deutschlandweiten Mammakarzinom-Kohorte

Information und Programm: www.senologiekongress.de, May 1, 2018

Research paper thumbnail of Exploring the current state of medical education in obstetrics and gynecology: A nationwide survey among German teaching coordinators

Research Square (Research Square), May 12, 2023

Background: Obstetrics and gynecology (OB/GYN) is an essential medical eld that focuses on women'... more Background: Obstetrics and gynecology (OB/GYN) is an essential medical eld that focuses on women's health. Universities aim to provide highquality healthcare services to women through comprehensive education of medical students. The objective of the present survey was both to ascertain perspectives on the teaching methods, resources, and challenges faced by medical educators in the eld of OB/GYN in Germany and to identify possible room from improvement. The survey was conducted with teaching coordinators from most German university OB/GYN departments. Methods: A questionnaire was sent to the teaching coordinators in all 41 OB/GYN departments at German university hospitals. The survey was delivered via email with a link to an online survey platform. Results: The study received 30 responses from 41 universities. In addition to standard teaching formats, such as lectures, seminars, and clinical clerkships, the universities differed in their additional teaching offerings. Gynecological history-taking and general gynecology had the highest rates of learning success, while sub elds such as reproductive medicine and urogynecology performed poorly. E-learning was found to be widely used and was considered advantageous. While good teaching was found to be essential and valued by students, a shortage of resources for medical education was noted. Conclusion: The present study provides valuable insights into the current state of medical education in OB/GYN at German universities from the perspective of teaching experts. We discuss approaches to overcoming current obstacles and offer suggestions for improvement. Background Obstetrics and gynecology (OB/GYN) is an essential medical eld that focuses on women's health. Providing medical students with comprehensive and up-to-date education in this area is vital to ensuring the delivery of high-quality healthcare services to women. In the German medical education system, only university hospitals and their a liated teaching hospitals are authorized to provide medical teaching, examinations, and licensing. Teaching coordinators-who hold an o cial position within a department (such as OB/GYN)-are appointed by the medical faculty and are usually senior physicians who work part-time in this role. Typically, one person with expertise and experience in medical teaching is responsible for the position in each medical department. Teaching coordinators are responsible for organizing and supervising all theoretical and practical student courses. They also develop the curriculum and implement innovative teaching formats within their respective departments. Moreover, along with other teaching coordinators from various departments, these coordinators often serve as members of the central decision-making body when it comes to coordinating medical teaching. Teaching coordinators usually also participate in teaching during lectures, seminars, and hands-on courses together with the teaching staff (1). Medical studies in Germany are divided into three phases and typically take six years in total to complete. The initial two pre-clinical years focus on fundamental sciences, such as biology, physics, anatomy, physiology, and (bio-)chemistry, and are followed by three years of comprehensive clinical education. The clinical curriculum encompasses all major and minor specialties, which are taught through lectures, seminars, and bedside teaching (2). The nal year-called the "Praktisches Jahr" (PJ)-involves full-time training in usually three 16-week blocks that consist of internal medicine, (general) surgery, and an elective specialty. The nal year allows students to gain hands-on experience in different medical settings, such as hospitals, clinics, and other healthcare facilities (3). As medical knowledge and practices constantly evolve, it is critical to regularly assess the status of medical education in OB/GYN and to identify any gaps or areas that require improvement. To that end, in cooperation with the Young Forum of the German Society for Gynecology and Obstetrics (i.e., the German interest group and organization of young physicians in training in OB/GYN), we conducted a nationwide survey among German teaching coordinators with the goal of exploring the current state of medical education in OB/GYN (4). The goal of the survey was to gather insights into the teaching methods, resources, and challenges faced

Research paper thumbnail of Diagnostic accuracy and clinical utility of axillary ultrasound in the evaluation of axillary lymph node status in early breast cancer patients

Geburtshilfe Und Frauenheilkunde, Oct 1, 2020

Research paper thumbnail of Veränderung des axillären Managements bei Brustkrebspatientinnen mit 1 – 2 tumorbefallenen Sentinel-Lymphknoten

Geburtshilfe Und Frauenheilkunde, Sep 20, 2018

Research paper thumbnail of Evaluation des Nutzens von intraoperativer Präparateradiografie zur Randbeurteilung bei brusterhaltender Therapie maligner Brusttumore

Geburtshilfe Und Frauenheilkunde, Sep 20, 2018

Research paper thumbnail of Oncologic outcomes for different axillary staging techniques in nodal positive breast cancer undergoing neoadjuvant systematic treatment: A cancer registry study

Journal of Clinical Oncology, Jun 1, 2023

e12571 Background: The optimal axillary staging technique for patients with nodal positive breast... more e12571 Background: The optimal axillary staging technique for patients with nodal positive breast cancer undergoing neoadjuvant systemic treatment (NAST) is unclear. Less invasive, targeted approaches like targeted axillary dissection (TAD) or sentinel-lymph node biopsy (SLNB) recently showed false-negative rates < 10% compared to axillary lymph node dissection (ALND). Oncologic outcomes, however, are unknown. Methods: We identified nodal positive breast cancer patients undergoing NAST from 2016 to 2021 with at least 1-year follow-up and available information regarding axillary staging from the state cancer registry of Baden-Wuerttemberg, Germany. Invasive disease-free survival (iDFS) was assessed using Kaplan-Meier statistics and multivariate cox regression models (adjusted for age, pN stage, pT stage, and tumor biologic subtype). Results: A total of 2403 patients with a median follow-up of 23.2-months after surgery were identified: 1963 underwent ALND, 407 underwent SLNB (in 230 cases, three or more sentinel nodes (SLNs) were removed and in 177 cases, 1-2 SLNs were removed), and 33 underwent TAD. The proportion of patients with pN+ stage within these four groups was 54%, 31%, 26%, and 35%, respectively ( P < 0.001). Significant differences in iDFS between the ALND, SLNB, and TAD groups were observed (log rank P = 0.046): iDFS 2 years after surgery was 74.5% (ALND), 80.2% (SLNB ≥3 removed SLNs), 85.6% (SLNB < 3 removed SLNs), and 88.4% (TAD), respectively. iDFS after 4 years was 61.5% (ALND), 69.1% (SLNB ≥3 removed SLNs), and 74.6% (SLNB < 3 removed SLNs), respectively. Multivariate cox regression analysis showed no significant influence of different axillary staging techniques on iDFS: HR 0.91 (95% CI 0.55 to 1.52) for SLNB with ≥3 removed SLNs, HR 0.99 (95% CI 0.59 to 1.67) for SLNB with < 3 removed SLNs (reference = ALND). Conclusions: This data suggests that ALND provides no benefit in terms of iDFS compared to targeted approaches like TAD or SLNB for patients with nodal positive breast cancer undergoing NAST. Future studies with longer-term follow-up are welcomed to fully inform this discussion.

Research paper thumbnail of The COVID-19 pandemic and its impact on medical teaching in obstetrics and gynecology – A nationwide expert survey among teaching coordinators at German university hospitals

Geburtshilfe Und Frauenheilkunde, Oct 1, 2022

Research paper thumbnail of Changes of breast and axillary surgery patterns in patients with primary breast cancer during the past decade

Archives of Gynecology and Obstetrics, Nov 26, 2018

Purpose Breast-conserving therapy (BCT) is the standard procedure for most patients with primary ... more Purpose Breast-conserving therapy (BCT) is the standard procedure for most patients with primary breast cancer (BC). By contrast, axillary management is still under transition to find the right balance between avoiding of morbidity, maintaining oncological safety, and performing a staging procedure. The rising rate of primary systemic therapy creates further challenges for surgical management. Methods Patients with primary, non-metastatic BC treated between 01.01.2003 and 31.12.2016 under guideline-adherent conditions were included in this study. For this prospectively followed cohort, breast and axillary surgery patterns are presented in a time-trend analysis as annual rate data (%) for several subgroups. Results Overall, 6700 patients were included in the analysis. While BCT rates remained high (mean 2003-2016: 70.4%), the proportion of axillary lymph node dissection has declined considerably from 80.1% in 2003 to 16.0% in 2016, while the proportion for sentinel lymph node biopsy (SLND) has increased correspondingly from 10.3 to 76.4%. Among patients with cT1-2, cN0 breast cancer receiving BCT with positive SLND, the rate of axillary completion has decreased from 100% in 2008 to 24.4% in 2016. Conclusions In the past decade, SLNB has been established as the standard procedure for axillary staging of clinically node-negative patients. Surgical morbidity has been further reduced by the rapid implementation of new evidence from the ACOSOG Z0011 trial into clinical routine. The results reflect the transition towards more individually tailored, less invasive treatment for selected patient subgroups, especially in regards to axillary lymph node management.

Research paper thumbnail of Präparateradiographie im Rahmen der brusterhaltender Therapie: Ein nützliches Instrument zur intraoperativen Randbeurteilung, auch nach neoadjuvanter Chemotherapie?

Research paper thumbnail of Erratum: PJ – EPAs und die Frauenheilkunde – Evaluation des Ist- und Soll-Zustands und dessen Diskrepanz

Geburtshilfe Und Frauenheilkunde, Oct 1, 2022

Research paper thumbnail of Can the organic coating of breast tissue markers be sampled by an ultrasound-guided vacuum-assisted biopsy? A comparative proof of concept evaluation of two coated clip marker types in turkey breasts

Geburtshilfe Und Frauenheilkunde, Oct 1, 2022

Research paper thumbnail of Can the organic coating of breast tissue markers be sampled by an ultrasound guided core-cut-biopsy? A comparative proof of concept evaluation of two coated clip marker types in turkey breasts

Research paper thumbnail of Breast biopsy management in patients under anticoagulation or antiplatelet therapy – results from a German Expert Survey

Research paper thumbnail of Die Bedeutung multimodaler Bildgebung und klinischer Informationen für Menschen und KI-basierte Algorithmen bei der Klassifikation von Brustläsionen (INSPiRED 003): eine internationale, multizentrische Analyse

Research paper thumbnail of Veränderungen in der Anwendung und beim Outcome von Chemotherapie beim frühen Mammakarzinom in der letzten Dekade

Geburtshilfe Und Frauenheilkunde, Aug 1, 2017

Research paper thumbnail of Evaluation von Shear-Wave-Elastographie als additives Tool zum Assessment axillärer Lymphknoten in der klinischen Routine

Wissenschaftliche Abstracts zur 40. Jahrestagung der Deutschen Gesellschaft für Senologie e.V. (DGS) Interdisziplinär. Kommunikativ. Digital, Jun 1, 2021

Research paper thumbnail of Does music genre affect medical students’ performance in standardized laparoscopic exercises? Comparing exposure to rock, hip-hop, classic and mixed radio music at 70 decibels

Geburtshilfe Und Frauenheilkunde, Oct 1, 2020

Research paper thumbnail of Veränderung des axillären Management nach Mastektomie bei Patientinnen mit tumorbefallenem Sentinel-Lymphknoten

Research paper thumbnail of Klaus-Dieter-Schulz-Versorgungsforschungspreis - Veränderungen in der Anwendung und beim Outcome von Chemotherapie beim frühen Mammakarzinom in der letzten Dekade (2003–2014)

Research paper thumbnail of Veränderungen in der Anwendung und beim Outcome von Chemotherapie beim frühen Mammakarzinom in der letzten Dekade (2003 – 2014)