[Utilization and utility of psycho-oncologic support of patients with mamma-carcinoma]. / Nutzung und Nutzen psychoonkologischer Versorgung bei Patientinnen mit Mamma-Karzinom.

OBJECTIVES: This study explores patients' utilization of psycho-oncologic support and the effectiveness thereof. METHODS: At the hospital in Munich-Harlaching, 51 patients were recruited following their first admission to the breast centre, 27 of whom utilized the psycho-oncologic service. They were compared to 24 decliners of the service. All patients completed self-rating questionnaires (Distress-Thermometer and Patient Health Questionnaire) at admission and at release. Group differences were calculated statistically by chi-square- and t-tests. RESULTS: We found no significant differences between users and decliners concerning socio-demographic and somatic data, but there were significant group differences in mental health. Users reported more mental distress and more depressive and anxiety symptoms. Psycho-oncologic interventions showed small to large effect sizes. CONCLUSIONS: Although this study corresponded more to external than to internal validity standards, it did yield provisional empirical evidence that psycho-oncologic interventions are effective in the treatment of the mental symptoms of breast cancer patients.

Primary mucinous adenocarcinoma of the vermiform appendix with high grade microsatellite instability.

Primary adenocarcinoma of the vermiform appendix is a rare entity and is frequently discovered by the pathologist following appendectomy for suspected appendicitis.We present a 42-year-old male with primary mucinous adenocarcinoma of the appendix initially presenting symptoms of acute appendicitis. Histological investigation of the appendectomy specimen showed a mucinous adenocarcinoma and the patient was treated by secondary right hemicolectomy giving the final histopathological classification of an UICC IIIC tumor. Since the patient fulfills the revised Bethesda criteria analysis of immunoreactivity of DNA mismatch repair proteins was performed showing loss of MLH1 and MSH2 expression associated with high microsatellite instability (MSI-H), not yet reported for primary mucinous appendiceal carcinoma. Further genetic analysis for DNA mismatch repair gene mutations were negative. The patient received intensified adjuvant chemotherapy according to the FOLFOX-4-scheme, since MSI-H colorectal carcinomas might show lower response rates following standard 5-FU-based adjuvant chemotherapy.