A Altendorf-Hofmann

Universitätsklinikum Jena, Jena, Thuringia, Germany

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Publications (96)253.34 Total impact

  • A. R. Mothes · M. P. Radosa · A. Altendorf-Hofmann · I. B. Runnebaum ·
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    ABSTRACT: To identify known risk factors for pelvic organ prolapse (POP) in a hospital cohort and to develop a prolapse risk index (PRI). Risk factors for POP were recorded in women who underwent surgery with symptomatic POP (n = 500) or non-POP gynaecological conditions (n = 236). Descriptive statistics were determined by Chi-squared and Mann-Whitney U tests. Stepwise multivariate regression analysis was performed for all patients and subgroups by age (<60 and ≥60 years). Primary outcome measures were variables with the strongest impact on prolapse and PRI development. Secondary: specificity, sensitivity, positive and negative predictive values (PPV and NPV, respectively), and Cohen's kappa statistic (κ). Stepwise multivariate regression analysis (n = 736) showed difficult obstetric history [odds ratio (OR) 10.04], family history of POP (OR 7.28), and ≥10 years since menopause (OR 4.53) were independent risk factors for prolapse (P < 0.001). When one of the three variables with the strongest influence on POP development was present, the PRI for all women showed a PPV of 82 %, NPV of 68 %, and κ of 0.47 for predicting symptomatic POP requiring treatment. In women under 60 years (n = 349), logistic regression revealed difficult obstetric history (OR 9.108), positive family history (OR 8.016), and body mass index (OR 2.274) as independent risk factors. Eighty-seven percent of our patient cohort with symptomatic POP requiring therapy could be identified by the PRI, which may be useful for counselling and education.
    Archives of Gynecology and Obstetrics 08/2015; DOI:10.1007/s00404-015-3863-2 · 1.36 Impact Factor
  • A Bauschke · A Altendorf-Hofmann · U Settmacher ·

    Zeitschrift für Gastroenterologie 08/2015; 53(08). DOI:10.1055/s-0035-1559475 · 1.05 Impact Factor
  • T Knösel · E Kampmann · T Kirchner · A Altendorf-Hofmann ·
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    ABSTRACT: The development of therapeutic agents that specifically target the molecular alterations critical for tumorigenesis has a tremendous impact on the management of cancer patients. The successful treatment of advanced gastrointestinal stromal tumors (GIST) with receptor tyrosine kinase (RTK) inhibitors has raised the hope that other malignancies could also benefit from a similar treatment. Tyrosine kinase receptors are promising targets for personalized medicine and new drugs are currently in phase 2 and phase 3 clinical trials. We analyzed a large cohort of soft tissue sarcomas for different tyrosine kinase receptors and correlated the results with clinicopathological parameters. A total of 275 soft tissue sarcomas from the Ludwig-Maximilians University (LMU) were revisited and catagorized according to the current World Health Organization (WHO) classification system. Different entities showed distinct survival curves in 10-year long-term survival. Furthermore, different subtypes of sarcomas showed distinct expression profiles at the protein level. The expression of vascular endothelial growth factor (VEGF) receptors is associated with tumor progression. Due to the fact that not all patients respond to RTK inhibitor therapy, protein signatures should be evaluated before targeting therapy to give a rationale for a viable personalized therapy.
    Der Pathologe 09/2014; 35(2). DOI:10.1007/s00292-014-1958-3 · 0.39 Impact Factor
  • S Schüle · A Altendorf-Hofmann · Y Dittmar · F Rauchfuß · U Settmacher ·
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    ABSTRACT: Even in patients with a history of solid malignant tumors, especially of gastrointestinal origin, newly diagnosed solid liver lesions do not necessarily correspond to metastases of the respective primary tumor. A reliable diagnosis can only be made by definitive histological examination. Data of all patients who underwent liver resection under the preoperative diagnosis of liver metastases between 1997 and 2011 and for whom liver specimens were examined histologically, were extracted from the prospectively maintained cancer registry. An unexpected histological result occurred in 47 out of 770 patients (6.1 %). Primary tumors in these patients included renal cell (n=12), colorectal (n=11), breast (n=8), gastric (n=4), pancreatic (n=3), skin (n=3) and other cancers (n=6). Liver lesions were diagnosed synchronously in 15 cases or metachronously after a median of 17 months following primary therapy in 32 patients. Histology revealed a benign tumor in 38 cases (81 %) as well as 6 cases of HCC, 2 cases of CCC and in 1 case metastasis of a previously unknown colorectal cancer in a patient with known esophageal carcinoma. Suspicion of metastatic disease was based on four different imaging modalities in two cases and on three different imaging modalities in nine cases. Either computed tomography (CT) or magnetic resonance imaging (MRI) was combined with ultrasound in another 23 patients and with positron emission tomography (PET) CT in 6 more cases. In two patients CT plus MRI and CT only, respectively, was performed. In the remaining three patients, suspicion of metastases occurred intraoperatively after macroscopic examination of the liver. Preoperative percutaneous biopsy was attempted in four patients with indeterminate results. Even with modern diagnostics the risk of treating a benign or other form of malignant tumor with neoadjuvant or palliative chemotherapy persists. The same holds true for local ablative procedures. Prior to local ablation or definitive palliative chemotherapy histological confirmation of metastases should be attempted.
    Der Chirurg 01/2014; 85(9). DOI:10.1007/s00104-013-2660-3 · 0.57 Impact Factor
  • Y Dittmar · A Altendorf-Hofmann · S Schüle · M Ardelt · O Dirsch · I B Runnebaum · U Settmacher ·
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    ABSTRACT: Purpose: Despite the development of modern chemotherapeutics and target-specific drugs as well as improved surgical techniques, prognosis of metastatic breast cancer remains poor. Only a small number of selected patients will be eligible for liver resection and/or alternative metastatic ablation. Data on prognostic factors for patients with surgically resectable liver metastases of breast cancer are scarce at present. Methods: From 1997 to 2010, 50 patients with hepatic metastases of breast cancer have undergone laparotomy with the intention to undergo a curative liver resection at our institution. Data from these patients were collected in a prospectively maintained standardized liver resection data base. Results: Liver resection was performed in 34 patients. Resection margins were clear in 21 cases (R0). Nine patients lived for more than 60 months after liver resection. The observed 5-year survival rate was 21% for all 50 patients, 28% for resected patients and 38% after R0-resection. On univariate analysis, survival rates of the resected patients were statistically significantly influenced by R-classification, age, extrahepatic tumour at the time of liver resection, size of metastases and HER2 expression of liver metastases. Multivariate analysis revealed absence of HER2 expression, presence of extrahepatic tumour and patient's age ≥50 years as independent factors of poor prognosis. Conclusions: Breast cancer patients younger than 50 years with technically resectable hepatic metastases, minimal extrahepatic tumour and positive HER2 expression appear to be suitable candidates for liver resection with curative intent. An aggressive multi-disciplinary management of those patients including surgical treatment may improve long-term survival.
    Journal of Cancer Research and Clinical Oncology 05/2013; 139(8). DOI:10.1007/s00432-013-1440-2 · 3.08 Impact Factor
  • S. Schuele · A. Altendorf-Hofmann · Y. Dittmar · T. Knoesel · U. Settmacher ·

    European Journal of Surgical Oncology 09/2012; 38(9):858-859. DOI:10.1016/j.ejso.2012.06.395 · 3.01 Impact Factor
  • M. Benkel · F. Brasch · J. Neumann · A. Altendorf-Hofmann · W. Sendt ·

    TumorDiagnostik &amp Therapie 06/2012; 33(04):230-231. DOI:10.1055/s-0032-1312852
  • W Sendt · C Wurst · U Settmacher · A Altendorf-Hofmann ·
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    ABSTRACT: Small bowel adenocarcinoma is a rare disease. The diagnosis is often disguised by nonspecific and varied presenting symptoms. Adenocarcinoma of the small bowel is typically detected at a late stage and with a poor prognosis. The records of 42 patients with small bowel adenocarcinomas diagnosed in 2 surgical clinics between 1995 and 2009 were reviewed for patient and tumor characteristics, treatment effects and survival. The tumor locations were the duodenum (50%), jejunum (38%) and ileum (12%). In comparison to patients seen before 2004 the observed frequency of emergency operations or palliative procedures as well as stage distribution did not change. The median overall survival was 19 months with a 5-year overall survival of 20%. For patients with resections, reduced performance status, higher stage and residual disease after resection predicted decreased overall survival in univariate analysis. Residual disease and pT category were predictive of survival in multivariate analysis. Complete resection provides the only means of a cure. In cases where curative resection cannot be performed the prognosis remains poor. Further study on the methods for early detection and effective adjuvant chemotherapy should be investigated, however, the available data are limited.
    Der Chirurg 09/2011; 83(4):374-80. · 0.57 Impact Factor
  • PD Dr. W. Sendt · C. Wurst · U. Settmacher · A. Altendorf-Hofmann ·
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    ABSTRACT: Hintergrund Dünndarmkarzinome sind insgesamt sehr selten. Die Diagnose ist häufig erschwert durch unspezifische und wechselnde Symptome. Adenokarzinome des Dünndarms werden häufig erst im fortgeschrittenen Stadium nachgewiesen, dann zumeist mit einer schlechten Prognose. Methodik Beschrieben werden Diagnostik, Therapie und Verlauf bei einer konsekutiven Serie von 42 Patienten mit Adenokarzinomen des Dünndarms, die zwischen 1995 und 2009 in zwei chirurgische Kliniken vorstellig wurden. Ergebnisse Die Tumoren waren bei 21 Patienten (50%) im Duodenum bei 16 (38%) im Jejunum und bei 5 (12%) im Ileum. Die 5-Jahres-Überlebensrate aller Patienten betrug 20% bei einer medianen Überlebenszeit von 19 Monaten. Statistisch signifikanten Einfluss auf die Überlebensraten bei den resezierten Patienten hatten univariat der präoperative Allgemeinzustand, die R-Klassifikation und das Tumorstadium. In der multivariaten Analyse erwiesen sich Residualtumor und pT-Kategorie als unabhängige Prognosefaktoren. Schlussfolgerung Die vollständige (R0) Tumorresektion stellt die einzige Chance auf Langzeitüberleben dar. Zukünftige Untersuchungen sollten sich daher auf die Früherkennung, aber auch auf adjuvante Therapieverfahren zielen. Gründe für die späte Diagnose sind wohl die geringe Spezifität der Symptome und die Seltenheit der Erkrankung.
    Der Chirurg 04/2011; 83(4). DOI:10.1007/s00104-011-2159-8 · 0.57 Impact Factor
  • M Benkel · F Brasch · J D Neumann · A Altendorf-Hofmann · W Sendt ·
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    ABSTRACT: BACKGROUND: Neuroendocrine tumours of the gastroenteropancreatic system (GEP-NETs) are rare, in particular those of the gallbladder. Due to the limited therapeutic options, surgical resection is favoured. CASE REPORT AND METHODS: Described below is the case of a 69-year-old male with a lymphogenically metastasising, poorly differentiated neuroendocrine carcinoma of the gallbladder who presented with unspecific abdominal pain. RESULTS AND CLINICAL COURSE: Following complete surgical resection of the tumour and the lymph node metastases he developed a recurrence 6  weeks post-operatively. The recurrence was treated with chemotherapy. Re-staging after three courses, however, showed further tumour progression. Prior to the start of a second-line treatment the patient died 13  weeks after surgery. CONCLUSIONS: This case demonstrates the complexity of this rare disease with diagnosis in advanced tumour stage and poor prognosis.
    Zentralblatt für Chirurgie 03/2011; 137(1):71-2. DOI:10.1055/s-0030-1262764 · 1.05 Impact Factor
  • I Petersen · B Günther · K Mildner · F Subhi · T Knösel · A Altendorf-Hofmann · D Katenkamp ·
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    ABSTRACT: The Jena Institute of Pathology has been serving as a consultation and reference center for soft tissue tumors in Germany since 1978. The present study provides an overview of the clinicopathological data from a two-year period and an update on diagnostics and research. Retrospectively, 7043 cases sent to the institute in the years 2006 and 2007 were analyzed. The majority of cases (>77.7%) were soft tissue tumors, of which 49% were categorized as malignant, 11.4% as intermediate, 35% as benign and 4.6% as tumors of uncertain biological potential. Neoplasms with fibroblastic differentiation were the most frequent. The mean age of patients with a sarcoma was 63 years. The molecular pathological analysis of soft tissue tumors has attained a major role in diagnosis. This is further advanced at the Jena institute in the context of a German Federal Ministry of Education and Research (BMBF) project for molecular sarcoma diagnosis with the aim of developing and validating DNA probes for in situ hybridization detection of translocations and their associated chromosomal breaks on the one hand, and DNA chips for the detection of fusion transcripts on the other. Research projects relate to the analysis of specific biomarkers in large tumor collectives and the pathomechanisms in several sarcoma entities.
    Der Pathologe 02/2011; 32(1):40-6. · 0.39 Impact Factor
  • O Guntinas-Lichius · T Wendt · J Buentzel · D Esser · P Lochner · A Mueller · S Schultze-Mosgau · A Altendorf-Hofmann ·
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    ABSTRACT: Head and neck in situ carcinoma is seldom diagnosed. Our knowledge about in situ cancer is limited. This study describes the epidemiology and prognosis of head and neck in situ cancer in Thuringia, Germany. We analyzed the cancer data of the Thuringian cancer registry database from 1996 to 2005. The database contained 3821 patients with primary head and neck cancer. Thirty-four patients (0.88%) had an in situ carcinoma. They were evaluated for patient's characteristics, tumor stage, incidence, treatment and trends in overall survival (OS) and recurrence-free survival (RFS). During 1996-2005, the average annual incidence of head and neck in situ carcinoma was 0.14 per 100,000 persons. Half of the cases were localized in the larynx. The patients were treated by local excision. Six patients (18%) developed a local recurrence. Only one recurrent tumor was diagnosed in early stage (rT1), but the other five tumors in advanced stage (rT3/rT4). The median time to recurrence was 27.43 months. For all 34 patients with in situ carcinoma, the 5-year OS was 84% and the 5-year RFS 60.4%. OS was better for laryngeal in situ cancer than for oral cavity or pharyngeal in situ cancer (p=0.031). The surveillance of patients with head and neck in situ carcinoma after treatment should be performed like in patients with invasive cancer, because nearly one fifth of patients developed a recurrence, predominantly in advanced stage.
    Oral Oncology 03/2010; 46(4):e5-9. DOI:10.1016/j.oraloncology.2010.01.005 · 3.61 Impact Factor
  • I. Petersen · B. Günther · K. Mildner · F. Subhi · T. Knösel · A. Altendorf-Hofmann · D. Katenkamp ·
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    ABSTRACT: Das Institut der Pathologie Jena ist seit 1978 als pathologisches Konsultations- und Referenzzentrum für Weichteiltumoren in Deutschland tätig. Die vorliegende Arbeit vermittelt einen Überblick über klinisch-pathologische Daten eines Zweijahreszeitaums und den aktuellen Stand von Diagnostik und Forschung. In einer retrospektiven Analyse wurden insgesamt 7043 Fälle ausgewertet, die dem Institut in den Jahren 2006 und 2007 übersandt wurden. Die Mehrheit von 77,7% bildete die Gruppe der Weichteiltumoren, von denen 49% als maligne, 11,4% als intermediär, 35% als benigne und 4,6% als Tumoren mit ungewissem biologischen Potenzial eingestuft wurden. Neoplasien mit fibroblastischer Differenzierung waren am häufigsten. Der Altersgipfel der Sarkome lag bei 63Jahren. Die molekularpathologische Diagnostik der Weichgewebstumoren hat mittlerweile einen großen Stellenwert und wird am Jenaer Institut im Rahmen eines BMBF-Verbundprojektes zur molekularen Sarkomdiagnostik weiterentwickelt. Dabei werden zum einen DNA-Sonden für die In-situ-Hybridisierung zum Nachweis von Translokationen bzw. den assoziierten Chromosomenbrüchen und zum anderen DNA-Chips zum Nachweis von Fusionstranskripten entwickelt und validiert. Forschungsprojekte zielen auf die Analyse von speziellen Biomarkern in größeren Kollektiven und auf das Verständnis von Pathomechanismen in unterschiedlichen Sarkomentitäten. The Jena Institute of Pathology has been serving as a consultation and reference center for soft tissue tumors in Germany since 1978. The present study provides an overview of the clinicopathological data from a two-year period and an update on diagnostics and research. Retrospectively, 7043 cases sent to the institute in the years 2006 and 2007 were analyzed. The majority of cases (>77.7%) were soft tissue tumors, of which 49% were categorized as malignant, 11.4% as intermediate, 35% as benign and 4.6% as tumors of uncertain biological potential. Neoplasms with fibroblastic differentiation were the most frequent. The mean age of patients with a sarcoma was 63years. The molecular pathological analysis of soft tissue tumors has attained a major role in diagnosis. This is further advanced at the Jena institute in the context of a German Federal Ministry of Education and Research (BMBF) project for molecular sarcoma diagnosis with the aim of developing and validating DNA probes for in situ hybridization detection of translocations and their associated chromosomal breaks on the one hand, and DNA chips for the detection of fusion transcripts on the other. Research projects relate to the analysis of specific biomarkers in large tumor collectives and the pathomechanisms in several sarcoma entities. SchlüsselwörterWeichteilsarkom–Klassifikation–Epidemiologie–Genetik–Molekulare Diagnostik KeywordsSarcoma, soft tissue–Classification–Epidemiology–Genetics–Molecular diagnostics
    Der Pathologe 02/2010; 32(1):40-46. DOI:10.1007/s00292-010-1399-6 · 0.39 Impact Factor
  • M. Götz · R. Wilutzky · A. Altendorf-Hofmann · U. Settmacher ·

    Verdauungskrankheiten 01/2010; 28(01):13-22. DOI:10.5414/VDP28013
  • U. Settmacher · A. Altendorf-Hofmann · K. Jandt · M. Heise ·
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    ABSTRACT: Das hepatozelluläre Karzinom (HCC) ist der häufigste primäre maligne Tumor der Leber. Therapeutische kurative Ansätze enthalten heute als zentrale Behandlungsmethode die radikale operative Entfernung des Tumors. Bei nicht zirrhotischen Lebern wird die Leberteilresektion eindeutig bevorzugt. Die Diagnose HCC wird meist aus der Bildgebung und einer Erhöhung des AFP-Werts (bei über 60% der Patienten mit einem HCC erhöht) gestellt. Eine bioptische Sicherung ist nur bei zweifelhaften, kleinen Knoten indiziert. Für die Langzeitprognose von Patienten mit einem HCC in Leberzirrhose sind im Wesentlichen der Tumor – Stadium, Aggressivität des Wachstums und Wachstumsrate –, der Allgemeinzustand und die Komorbidität, die Leberfunktion und die Therapie von Bedeutung. Betrachtet man die Therapieoption Lebertransplantation bei Patienten mit einem auf die Leber beschränkten HCC in Zirrhose formal, so erreicht man in dieser Situation mit der Behandlungsmethode eine radikale Tumorentfernung mit gleichzeitiger Behandlung der Grunderkrankung Zirrhose (als Präkanzerose). In der Eurotransplant-Region (seit 15.12.06) wie auch in den USA werden Patienten heute gemäß funktionellen Kriterien nach dem MELD der Dringlichkeit nach gelistet. Die Mailänder Kriterien, die einem Patienten in vielen Transplantationsregionen ermöglichen, zusätzliche Punkte der Dringlichkeit auf den Wartelisten zu erreichen, sind in Diskussion. Die postmortale Organspende erfolgt bei Patienten mit einem HCC technisch genauso wie die bei Patienten mit einer benignen Grunderkrankung. Hepatocellular cancer (HCC) is the most common primary malignant tumor of the liver. The main method of treatment for therapeutic curative approaches is nowadays radical surgical removal of the tumor. For non-cirrhotic livers a partial resection is definitely preferable. The diagnosis of HCC is mostly achieved by imaging and an elevated AFP value (more than 60% of patients with HCC have elevated AFP). A biopsy for confirmation is only considered necessary for questionable small lumps, not for large ones. Important factors for the long-term prognosis for patients with HCC and liver cirrhosis are i) the tumor stage, aggressiveness of growth and growth rate, ii) the general condition and comorbidity, iii) liver function and iv) therapy. If the therapy option of liver transplantation for patients with HCC limited to a cirrhotic liver is formally considered, the treatment method of radical removal of the tumor also achieves a parallel treatment of the underlying cirrhosis (as precancerous). In the Eurotransplant region (since 15.12.2006), as well as in the USA, patients are nowadays listed according to functional criteria of urgency according to MELD. The Milan criteria, which allow a patient to attain additional urgency points in the waiting list in many transplantation regions, are under discussion. Post-mortem organ donation can occur for patients with HCC technically in exactly the same way as for patients with a benign underlying disease.
    Der Onkologe 06/2009; 15(6):575-588. DOI:10.1007/s00761-008-1557-0 · 0.14 Impact Factor
  • W Sendt · T Weber · S Retschke · A Altendorf-Hofmann ·
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    ABSTRACT: Symptomatic congenital cysts of the liver, whether solitary or multiple in appearance, can be treated by a laparoscopic approach. Here we present our single centre experience encompassing a rather large cohort of patients. From our prospective surgical database, introduced for quality management and surveillance, we identified 34 consecutive patients who were operated on for congenital liver cysts between 1995 and 2004. Using a questionnaire, the patients were contacted to assess actual complaints, the recurrence of operated cysts or the frequency of newly developed cysts. During follow-up two patients had died of other diseases. Of the remaining 32 patients 30 answered the questionnaire (94 %). The median postoperative follow-up was 55 months (range: 8-121). There were 29 women and 5 men with solitary (n = 10) or multiple (n = 20) liver cysts and polycystic liver disease (n = 4), all complained of unspecific upper abdominal pain. Due to previous operations or coexisting diseases open laparotomy was performed in 7 patients and laparoscopic unroofing was performed in 27 patients. The conversion rate to open laparotomy was 7 % (n = 2). Solitary cysts were unroofed in 25 patients and multiple cysts in 8 patients. The resected cysts had a median diameter of 10.5 cm (solitary cysts: 7-19 cm, multiple cysts: 4-23 cm). The only postoperative complications were 3 cases of bilioma (8.9 %), which required open revision in one case. There were no cysts recurrences, but persisting upper gastrointestinal pain, backache or problems arising from the scars were reported by 9 patients (30 %). In cases of symptomatic congenital liver cysts laparoscopic unroofing should be considered the treatment of choice.
    Zentralblatt für Chirurgie 05/2009; 134(2):149-54. · 1.05 Impact Factor
  • W. Sendt · T. Weber · S. Retschke · A. Altendorf-Hofmann ·

    Zentralblatt für Chirurgie 04/2009; 134(02):149-154. DOI:10.1055/s-0028-1098700 · 1.05 Impact Factor
  • U. Settmacher · A. Altendorf-Hofmann · K. Jandt · M. Heise ·

  • Krobot KD · D Yin · Q Zhang · S Sen · A Altendorf-Hofmann · J Scheele · W Sendt ·
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    ABSTRACT: To assess the significance of initial empiric parenteral antibiotic therapy in patients requiring surgery for community-acquired secondary peritonitis, 425 patients hospitalized between January 1999 and September 2001 in 20 clinics across Germany were followed for a total of 6,521 patient days. Perforated appendix (38%), colon (27%), or gastroduodenum (22%) were the most common sites of infection. Escherichia coli was the most common pathogen. A total of 54 (13%) patients received inappropriate initial parenteral therapy not covering all bacteria isolated, or not covering both aerobes and anaerobes in the absence of culture results. Clinical success, predefined as the infection resolving with initial or step-down therapy after primary surgery, was achieved in 322 patients (75.7%; 95% confidence interval (CI), 70.6-81.2). Patients were more likely to have clinical success if initial antibiotic therapy was appropriate (78.6%; 95% CI, 73.6-83.9) rather than inappropriate (53.4%; 95% CI, 41.1-69.3). Patients having clinical success were estimated to stay 13.9 days in hospital (95% CI, 13.1-14.7), while those who had clinical failure stayed 19.8 days (95% CI, 17.3-22.3). In conclusion, appropriateness of initial parenteral antibiotic therapy was a predictor of clinical success, which in turn was associated with length of stay.
    European Journal of Clinical Microbiology 10/2004; 23(9):682-7. DOI:10.1007/s10096-004-1199-0 · 2.67 Impact Factor
  • A Altendorf-Hofmann · E Schulze · D Katenkamp · J Scheele · P Hermanek ·
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    ABSTRACT: Current tumor management is increasingly founded on interdisciplinary cooperation. The main partners in cases of solid tumors are oncologic surgery, medical oncology,and radiotherapy, guided by pathology. The cooperative concept, particularly the individual strategy and selection of the most adequate approach, oriented on guidelines and therapeutic standards, depends on the quality of the involved components as well as personal abilities of the "actors." In addition to the personal qualification, decision making depends on both tumor stage and completeness of tumor removal. In this point, the overall quality of the therapeutic concept is based on an interaction between the operating surgeon and clinical pathologist that had seldom been taken into consideration. The basic rules of their cooperation and quality-focused implementation regarding tumor dignity, stage, and R classification are discussed based on the example of colorectal carcinoma. In particular, those pitfalls in tumor documentation are emphasized,which may appear less relevant for each partner individually, but bear the risk of misinterpretation and therefore misleading conclusions.
    Der Chirurg 05/2003; 74(4):375-80. · 0.57 Impact Factor

Publication Stats

4k Citations
253.34 Total Impact Points


  • 2001-2014
    • Universitätsklinikum Jena
      • Klinik für Allgemein-, Viszeral- und Gefäßchirurgie
      Jena, Thuringia, Germany
  • 1999-2014
    • Friedrich Schiller University Jena
      • Clinic of General, Visceral and Vascular Surgery
      Jena, Thuringia, Germany
  • 1997-1999
    • Alfried Krupp Krankenhaus
      Essen, Lower Saxony, Germany
  • 1992-1999
    • Friedrich-Alexander Universität Erlangen-Nürnberg
      Erlangen, Bavaria, Germany
  • 1990-1998
    • Universitätsklinikum Erlangen
      • Department of Surgery
      Erlangen, Bavaria, Germany
    • Ottawa Regional Cancer Foundation
      Ottawa, Ontario, Canada
  • 1995
    • Freie Universität Berlin
      Berlín, Berlin, Germany