O Ortmann

University Hospital Regensburg, Ratisbon, Bavaria, Germany

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Publications (460)915.52 Total impact

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    ABSTRACT: The aim of the present study was to evaluate to what extent the combination of standard histopathological parameters determines the biology of breast cancer and the effect on therapy and prognosis. The Clinical Cancer Registry Regensburg (Bavaria, Germany) included n = 4,480 female patients with primary, non-metastatic (M0) invasive breast cancer diagnosed between 2000 and 2012. Immuno-histochemical analyses, i.e., estrogen receptor (ER), progesterone receptor (PR), HER2, and Ki-67 (4-IHC), defined the tumor biological subtypes Luminal A, Luminal B, HER2-like, and Basal-like. Subtype-related differences in therapies and overall survival (OS) were analyzed using multivariable statistical methods. 4344 patients (97.0 %) could be classified into the four common tumor biological subtypes. The two most frequent entities were Luminal A (48.4 %), Luminal B (24.8 %), HER2-like (17.8 %), and Basal-like subtype (9.0 %). A multivariable Cox regression model showed that the best 7-year OS was seen in Luminal A patients and that OS of Luminal B and HER2-like patients was comparable (HR = 1.59, P < 0.001 versus HR = 1.51, P = 0.03). Lowest OS was seen in patients with Basal-like tumors (HR = 2.18, P < 0.001). In conclusion, the classification of tumor biological subtypes by the ER, PR, HER2, and Ki-67 biomarkers is practical in routine clinical work. Providing that quality assurance of these markers is ensured, this classification is useful for making therapy decisions in the routine clinical management of breast cancer patients.
    Breast Cancer Research and Treatment 09/2015; DOI:10.1007/s10549-015-3572-3 · 3.94 Impact Factor
  • O Ortmann
    Archives of Gynecology 08/2015; 292(4). DOI:10.1007/s00404-015-3829-4 · 1.36 Impact Factor
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    ABSTRACT: Adjuvant endocrine therapy (ET) is indicated in patients with steroid hormone receptor (HR)-positive breast cancer. The aim of this study was to evaluate the quality of HR determination and adjuvant endocrine treatment of breast cancer patients in a large cohort of more than 7000 women by analyzing data from a population-based regional cancer registry. Data from the Clinical Cancer Registry Regensburg (Bavaria, Germany) were analyzed. Female patients with primary, nonmetastatic invasive breast cancer who were diagnosed between 2000 and 2012 (n = 7421) were included. HR-status was available in 97.4 % (n = 7229) of the patients. This data set (n = 7229) was used for subsequent statistical analyses. Since 2009, almost a complete rate of 99.6 % of analyzed HR-status was achieved. In sum, 85.8 % of the patients (n = 6199) were HR-positive, whereas 14.2 % (n = 1030) were HR-negative. Overall, 85.3 % (n = 5285) of HR-positive patients received ET either alone or in combination with chemotherapy (CHT) and/or trastuzumab. The majority of premenopausal patients received CHT plus ET (716 patients, 52.3 %). In postmenopausal patients, the most frequent systemic therapy was ET alone (2670 patients, 55.3 %). Best overall survival (OS) was found in HER2-/HR-positive patients receiving CHT plus ET plus trastuzumab (7-year OS rate of 97.2 % in premenopausal patients versus 86.9 % in postmenopausal patients). Premenopausal patients had a reduced benefit from additional CHT than postmenopausal patients. Premenopausal patients receiving only ET had a 7-year OS rate of 95.3 % compared to 92.7 % of patients receiving CHT plus ET. In contrast, postmenopausal patients treated with CHT plus ET had a 7-year OS rate of 84.0 % in comparison with those patients receiving only ET with a 7-year OS rate of 81.7 %. Analysis of HR in patients with early breast cancer achieved a very high quality in recent years. The vast majority of HR-positive patients received ET, and this guideline-adherent use improved OS. Inverse effects of the CHT plus ET combination in premenopausal versus postmenopausal patients and a still existing minority of patients not receiving guideline-adherent treatment should be further investigated in future studies.
    Journal of Cancer Research and Clinical Oncology 08/2015; DOI:10.1007/s00432-015-2025-z · 3.08 Impact Factor
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    G Donders · G Bellen · P Neven · P Grob · V Prasauskas · S Buchholz · O Ortmann
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    ABSTRACT: This study was a detailed microscopic analysis of the changes of vaginal microflora characteristics after application of 0.03 mg estriol-lactobacilli combination on the vaginal ecosystem in postmenopausal breast cancer (BC) survivors on aromatase inhibitors (AI) with severe atrophic vaginitis. A total of 16 BC women on AI applied daily one vaginal tablet of Gynoflor® for 28 days followed by a maintenance therapy of three tablets weekly for 8 weeks. During four follow up visits a smear from the upper lateral vaginal wall was analysed by phase contrast microscopy at 400 times magnification in order to classify the lactobacillary grades(LBG), bacterial vaginosis (BV), aerobic vaginitis (AV), vulvovaginal candidosis (VVC), proportional number of leukocytes and evidence of parabasal cells and epitheliolysis. LBG improved from 81 % LBG-III at entry to 88 % LBG-I&IIa after 2 weeks of initial therapy, which further improved upon follow up (p < 0.001). Whereas BV was a rare event, AV was frequent and substantially improved during treatment (p < 0.01). While at entry most patients had moderate or severe AV, after maintenance therapy no patient except one had AV. The number of leukocytes dropped dramatically from a score of 1.78 ± 0.70 to 1.06 ± 0.25 which was consistent till the end of the study (p < 0.01). Parabasal cells dropped from a score of 3.4 ± 0.64 at entry to 1.3 ± 0.60 at the final visit (p trend < 0.01). Starting from a low rate of Candida colonisation of 2/14 (14 %), a sudden rise to 7/16 (44 %) occurred after 2 weeks, to return back to base levels at susequent visits. The vaginal use of ultra-low dose estriol and lactobacilli results in rapid and enduring improvement of all markers of the vaginal microflora and epithelial vaginal cell quality in women with breast cancer on AI with dyspareunia. Candida may develop soon after its use, but rapidly disappears again upon their prolonged use. Due to its excellent safety profiles and clinical efficacy we recommend this product as first choice in women on AI with severe dyspareunia.
    European Journal of Clinical Microbiology 07/2015; DOI:10.1007/s10096-015-2447-1 · 2.67 Impact Factor
  • O. Ortmann · U. Lang · S. Seitz
    Geburtshilfe und Frauenheilkunde 07/2015; 75(06):525-525. DOI:10.1055/s-0035-1546224 · 0.94 Impact Factor
  • S Schüler · C Lattrich · J Häring · O Treeck · O Ortmann
    Geburtshilfe und Frauenheilkunde 07/2015; 75(06). DOI:10.1055/s-0035-1555064 · 0.94 Impact Factor
  • M Ponnath · J Christ · D Günther · O Ortmann · U Germer
    Geburtshilfe und Frauenheilkunde 07/2015; 75(06). DOI:10.1055/s-0035-1555061 · 0.94 Impact Factor
  • Geburtshilfe und Frauenheilkunde 07/2015; 75(06). DOI:10.1055/s-0035-1555063 · 0.94 Impact Factor
  • Senologie - Zeitschrift für Mammadiagnostik und -therapie 05/2015; 12(02). DOI:10.1055/s-0035-1550529
  • Senologie - Zeitschrift für Mammadiagnostik und -therapie 05/2015; 12(02). DOI:10.1055/s-0035-1550543
  • Senologie - Zeitschrift für Mammadiagnostik und -therapie 05/2015; 12(02). DOI:10.1055/s-0035-1550506
  • Senologie - Zeitschrift für Mammadiagnostik und -therapie 05/2015; 12(02). DOI:10.1055/s-0035-1550572
  • The Breast 03/2015; 24:S39. DOI:10.1016/S0960-9776(15)70086-X · 2.38 Impact Factor
  • Olaf Ortmann · U Helbig · J Torode
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    ABSTRACT: Bringing the knowledge and expertise of different European countries and the European Commission together for an analysis of the different factors being beneficent or rather opposing for high quality in cancer care. A specific focus is set on the structures and views in European nations on implementation processes. Due to the variation of National Cancer Control Plans (NCCPs) the preferences for implementation strategies differ. For quality achievement the involvement of the different stakeholders is beneficial. Common sense was the importance of NCCPs. However, it was consensus between participants that a bottom-up approach that considers the needs of different professional groups involved in cancer care and also the views of patients is of critical importance for successful implementation. Functioning cancer registries and evidence-based guidelines with standard of care are fundamental for quality measurement. There is consensus between participants of the meeting that NCCPs are essential for improvement of cancer care. However, national preferences and the views of patients and caregivers have to be included to guarantee successful implementation.
    Journal of Cancer Research and Clinical Oncology 02/2015; DOI:10.1007/s00432-014-1906-x · 3.08 Impact Factor
  • Asia-Pacific Journal of Clinical Oncology 12/2014; 10:73-74. · 1.54 Impact Factor
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    ABSTRACT: ABSTRACT Objective: We investigated the effect of a combination of vaginal ultra-low-dose estriol with lactobacilli on the sexual functioning domain of quality of life (QOL) during the treatment of breast cancer (BC) survivors on an aromatase inhibitor (AI) with vaginal atrophy. Subjects and Methods: This was an open label bicentric exploratory clinical study, in 16 postmenopausal BC survivors on AI suffering from vaginal atrophy-induced sexual disorders. Atrophy symptoms were assessed by scoring with an 11-point estimation scale (0 = not at all, 10 = worst imaginable feeling). Sexuality parameters of QOL and medication adherence were recorded in patient's diary and in 'Female Somatic Sexual Experience Instrument (FSSEI) questionnaire. Patients underwent an initial treatment for 4 weeks (1 vaginal tablet of Gynoflor(®) containing 0.03 mg estriol daily), followed by maintenance therapy (3 vaginal Gynoflor(®) tablets weekly) for 8 weeks. Results: Vaginal dryness continuously improved from a median score 8 at entry to score 4 at the end of initial therapy, and median score 2 at the end of maintenance therapy. Normal sexual activity before BC diagnosis was reported by 14 women (88%). At study entry only 3 women (19 %) were sexually active. At the end of the Gynoflor(®) regimen, 10 women (63%) reported sexual activity, of which 7 (44%) sexual intercourse. The FSSEI demonstrated a non-significant trend of improvement of parameters related to sexuality Conclusions: Local vaginal therapy with Gynoflor(®) in BC survivors on AIs reporting atrophic vaginitis could be considered as a useful treatment the quality of the sexual life.
    Climacteric 11/2014; DOI:10.3109/13697137.2014.991301 · 2.26 Impact Factor
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    ABSTRACT: Triple negative breast cancer (TNBC) is a distinct subtype of breast cancer burdened with a dismal prognosis due to the lack of effective therapeutic agents. Receptors for LHRH (luteinizing hormone-releasing hormone) can be successfully targeted with AEZS-108 [AN-152], an analog of LHRH conjugated to doxorubicin. Our study evaluates the presence of this target LHRH receptor in human specimens of TNBC and investigates the efficacy and toxicity of AEZS-108 in vivo. We also studied in vitro activity of AEZS-125, a new LHRH analog conjugated with the highly potent natural compound, Disorazol Z. 69 human surgical specimens of TNBC were investigated for LHRH-R expression by immunohistochemistry. Expression of LHRH-R in two TNBC cell lines was evaluated by real time RT-PCR. Cytotoxicity of AEZS-125 was evaluated by Cell Titer Blue cytoxicity assay. LHRH- receptor expression was silenced with an siRNA in both cell lines. For the in vivo experiments an athymic nude mice model xenotransplanted with the cell lines, MDA-MB-231 and HCC 1806, was used. The animals were randomised to three groups receiving solvent only (d 1, 7, 14, i.v.) for control, AEZS-108 (d 1, 7, 14, i.v.) or doxorubicin at an equimolar dose (d 1, 7, 14, i.v.). In human clinical specimens of TNBC, expression of the LHRH-receptor was present in 49% (n = 69).HCC 1806 and MDA-MB-231 TNBC cells expressed mRNA for the LHRH-receptor. Silencing of the LHRH-receptor significantly decreased the cytotoxic effect of AEZS-108. MDA-MB-231 and HCC 1806 tumors xenografted into nude mice were significantly inhibited by treatment with AEZS-108; doxorubicin at equimolar doses was ineffective.As compared to AEZS 108, the Disorazol Z - LHRH conjugate, AEZS-125, demonstrated an increased cytotoxicity in vitro in HCC 1806 and MDA-MB-231 TNBC; this was diminished by receptor blockade with synthetic LHRH agonist (triptorelin) pretreatment. The current study confirms that LHRH-receptors are expressed by a significant proportion of TNBC and can be successfully used as homing sites for cytotoxic analogs of LHRH, such as AEZS-108 and AEZS-125.
    BMC Cancer 11/2014; 14(1):847. DOI:10.1186/1471-2407-14-847 · 3.36 Impact Factor
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    ABSTRACT: Purpose: Vascular disease is the leading cause of death in women. One-third of acute events affect women below age 60, when the prevalence of menopausal symptoms is high. This raises the question if hormone replacement therapy (HRT) may be an appropriate treatment for individual women although vascular disease is generally considered a contraindication. Methods: Selective literature search was used for this study. Results: In healthy women, HRT increases risks for venous thromboembolism and ischemic stroke, but for cardiovascular disease apparently only beyond 10 years after menopause or 60 years of age. Limited data in women with cardio or cerebrovascular disease have not demonstrated an increased risk for a vascular recurrent event, but for the first year after initiation. In HRT users affected by a cardiovascular event continuation of HRT has not been found to be associated with adverse outcome. Low dose estradiol--preferentially as transdermal patches, if necessary combined with metabolically neutral progestins--appears to convey lower risk. Conclusions: Safety data on HRT in survivors of cardiovascular events or ischemic stroke are limited, but exceptionally increased risk appears to be excluded. If off-label use of HRT is considered to be initiated or continued in women with cardio- or cerebrovascular disease, extensive counseling on the pros and cons of HRT is mandatory.
    Archives of Gynecology and Obstetrics 10/2014; 291(1). DOI:10.1007/s00404-014-3485-0 · 1.36 Impact Factor
  • B Gerber · O Ortmann
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    ABSTRACT: Introduction The effect of GnRHa in the preservation of ovarian function during a modern chemotherapy is still under discussion. Material and Method In this News and Views article, we discuss the benefits and weaknesses of the recently presented POEMS. Results The POEM study demonstrated an increased resumption of ovarian function and pregnancy rate after using GnRHa. GnRHa in HR-negative patients led to a significant increase in disease free and overall survival, with those effects being inexplicable. Weaknesses of the trial were prematurely close due to lack of recruitment, a drop-out rate of 38 % during follow-up and definition of hormone receptor negativity by
    Archives of Gynecology and Obstetrics 10/2014; 290(6). DOI:10.1007/s00404-014-3493-0 · 1.36 Impact Factor
  • C W Kwok · O Treeck · S Buchholz · S Seitz · O Ortmann · J B Engel
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    ABSTRACT: Triple negative breast cancers express receptors for gonadotropin-releasing hormone (GnRH) in more than 50 % of the cases, which can be targeted with peptidic analogs of GnRH, such as triptorelin. The current study investigates cytotoxic activity of triptorelin as a monotherapy and in treatment combinations with chemotherapeutic agents and inhibitors of the PI3K and the ERK pathways in in vitro models of triple negative breast cancers (TNBC). GnRH receptor expression of TNBC cell lines MDA-MB-231 and HCC1806 was investigated. Cells were treated with triptorelin, chemotherapeutic agents (cisplatin, docetaxel, AEZS-112), PI3K/AKT inhibitors (perifosine, AEZS-129), an ERK inhibitor (AEZS-134), and dual PI3K/ERK inhibitor AEZS-136 applied as single agent therapies and in combinations. MDA-MB-231 and HCC1806 TNBC cells both expressed receptors for GnRH on messenger (m)RNA and protein level and were found sensitive to triptorelin with a respective median effective concentration (EC50) of 31.21 ± 0.21 and 58.50 ± 19.50. Synergistic effects occurred when triptorelin was combined with cisplatin. In HCC1806 cells, synergy occurred when triptorelin was applied with PI3K/AKT inhibitors perifosine and AEZS-129. In MDA-MB-231 cells, synergy was observed after co-treatment with triptorelin and ERK inhibitor AEZS-134 and dual PI3K/ERK inhibitor AEZS-136. GnRH receptors on TNBC cells can be used for targeted therapy of these cancers with GnRH agonist triptorelin. Treatment combinations based on triptorelin and PI3K and ERK inhibitors and chemotherapeutic agent cisplatin have synergistic effects in in vitro models of TNBC. If confirmed in vivo, clinical trials based on triptorelin and cisplatin could be quickly carried out, as triptorelin is FDA approved for other indications and known to be well tolerated.
    Targeted Oncology 10/2014; 10(3). DOI:10.1007/s11523-014-0340-y · 4.00 Impact Factor

Publication Stats

4k Citations
915.52 Total Impact Points


  • 2009–2014
    • University Hospital Regensburg
      • Institut für Pathologie
      Ratisbon, Bavaria, Germany
    • South Florida Veterans Affairs Foundation for Research and Education
      Miami, Florida, United States
    • St. Josef-Hospital
      Bonn, North Rhine-Westphalia, Germany
  • 2005–2014
    • Caritas-Krankenhaus St. Josef
      Ratisbon, Bavaria, Germany
  • 2003–2014
    • Universität Regensburg
      • Department of Gynecology and Obstetrics
      Ratisbon, Bavaria, Germany
  • 2012
    • Medical University of Lublin
      • Department of Gynecology
      Lyublin, Lublin Voivodeship, Poland
  • 2011
    • University of Texas MD Anderson Cancer Center
      • Department of Molecular Pathology
      Houston, TX, United States
  • 1985–2003
    • Universität zu Lübeck
      • • Department of Obstetrics and Gynecology
      • • Klinik für Frauenheilkunde und Geburtshilfe
      Lübeck Hansestadt, Schleswig-Holstein, Germany
  • 1991–2000
    • Philipps University of Marburg
      Marburg, Hesse, Germany
  • 1990
    • West Georgia Obstetrics and Gynecology
      Georgetown, Georgia, United States
  • 1988–1989
    • National Institute of Child Health and Human Development
      Maryland, United States