A Altendorf-Hofmann

Friedrich Schiller University Jena, Jena, Thuringia, Germany

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Publications (96)243.43 Total impact

  • A. Bauschke · A. Altendorf-Hofmann · H. Mothes · F. Rauchfuß · U. Settmacher
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    ABSTRACT: Purpose The number of elderly patients with HCC will increase worldwide in the next years. Therefore, surgeons need to reassess clinical algorithms for the treatment of patients with HCC. We reevaluated a cohort of patients treated in the last 10 years at our hospital, with emphasis on long-term results and age. Method A prospectively recorded consecutive series of all patients treated in between January 1995 and December 2014 with curative intent either by partial liver resection or by ablative therapy was analysed. Results At the time of diagnosis, 232 patients were younger than 70 years and 127 patients were aged 70 years and over. In the latter group, solitary tumours, absence of liver cirrhosis and resection therapy were more frequent compared to younger patients. Charlson index, AFP-negative tumours and CLIP score were equally distributed in both groups. Observed survival of older and younger patients was similar but after partial liver resection, younger patients had a better survival than elderly patients, whereas survival in patients treated with ablation was similar in both groups. In the univariate analysis, long-term survival of patients aged 70 years and over was influenced by treatment procedure, number of lesions, liver cirrhosis, Child’s stage and CLIP score. In the multivariate analysis, only treatment procedure and CLIP score were identified as independent predictors of observed survival, and comorbidity was not. Conclusion In patients aged 70 years and over, long-term prognosis is independently influenced by CLIP score and treatment procedure and other findings have only minor influence on long-term survival.
    No preview · Article · Jan 2016 · Journal of Cancer Research and Clinical Oncology
  • 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.
    No preview · Article · Aug 2015 · Archives of Gynecology and Obstetrics
  • A Bauschke · A Altendorf-Hofmann · U Settmacher

    No preview · Article · Aug 2015 · Zeitschrift für Gastroenterologie
  • 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.
    No preview · Article · Sep 2014 · Der Pathologe
  • S. Schüle · Y. Dittmar · A. Altendorf-Hofmann · U. Settmacher
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    ABSTRACT: Liver resection for metastatic colorectal or neuroendocrine carcinomas has been a widely accepted curative therapy for many years; data on metastasectomy for other tumour entities, however, is less clear. Isolated liver metastases occur but rarely in carcinomas of gynaecologic origin, yet the presence of controlled or resectable extrahepatic metastases does not preclude a surgical approach. Metastatic breast cancer constitutes the most frequent indication resulting in a median survival of 32-58 months following liver resection, which is a considerable extension of survival in comparison to palliative chemotherapy only. In ovarian cancer, survival after liver metastasectomy depends on the degree of cytoreduction and is reported between 38-98 months in the ideal case. Liver metastases of carcinomas or sarcomas of the cervix, the endometrium or the Fallopian tubes are seen so infrequently that only few cases have been published worldwide. Liver resection may be considered in these cases, but must be regarded as a highly individual decision due to the lack of data.
    No preview · Article · Mar 2014
  • 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.
    No preview · Article · Jan 2014 · Der Chirurg
  • 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.
    No preview · Article · May 2013 · Journal of Cancer Research and Clinical Oncology
  • S. Schuele · A. Altendorf-Hofmann · Y. Dittmar · T. Knoesel · U. Settmacher

    No preview · Article · Sep 2012 · European Journal of Surgical Oncology
  • M. Benkel · F. Brasch · J. Neumann · A. Altendorf-Hofmann · W. Sendt

    No preview · Article · Jun 2012 · TumorDiagnostik & Therapie
  • 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.
    No preview · Article · Sep 2011 · Der Chirurg
  • 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.
    No preview · Article · Apr 2011 · Der Chirurg
  • 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.
    No preview · Article · Mar 2011 · Zentralblatt für Chirurgie
  • 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.
    No preview · Article · Feb 2011 · Der Pathologe
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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.
    No preview · Article · Mar 2010 · Oral Oncology
  • 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.
    No preview · Article · Feb 2010 · Der Pathologe
  • M. Götz · R. Wilutzky · A. Altendorf-Hofmann · U. Settmacher
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    ABSTRACT: Hepatocellular carcinoma (HCC) is the most common malignant primary liver tumor. Regardless of the underlying cause cirrhosis of the liver is considered to be a precancerous stage. The diagnosis of HCC results from at least two independent dynamic imaging studies (CT, ultrasound or MRI). The only curative approach is surgical removal of the tumor. This can be achieved either by resection of the tumor tissue or by removal of the whole liver and transplantation of a donor organ. Resection is the gold standard for treatment of HCC in non-cirrhotic patients. Patients with underlying liver cirrhosis and HCC benefit from a liver transplantation with respect to long-term survival. Further studies to evaluate a scoring system that includes different factors for exact prediction of the outcome after liver transplantation are needed.
    No preview · Article · Jan 2010 · Verdauungskrankheiten
  • M. Götz · R. Wilutzky · A. Altendorf-Hofmann · U. Settmacher

    No preview · Article · Jan 2010 · Verdauungskrankheiten
  • U. Settmacher · A. Altendorf-Hofmann · K. Jandt · M. Heise
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    ABSTRACT: 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.
    No preview · Article · Jun 2009 · Der Onkologe
  • 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.
    No preview · Article · May 2009 · Zentralblatt für Chirurgie
  • W. Sendt · T. Weber · S. Retschke · A. Altendorf-Hofmann

    No preview · Article · Apr 2009 · Zentralblatt für Chirurgie

Publication Stats

4k Citations
243.43 Total Impact Points

Institutions

  • 1999-2015
    • Friedrich Schiller University Jena
      • • Clinic of General, Visceral and Vascular Surgery
      • • Institute of Pathology
      Jena, Thuringia, Germany
  • 2001-2014
    • Universitätsklinikum Jena
      • Klinik für Allgemein-, Viszeral- und Gefäßchirurgie
      Jena, Thuringia, Germany
  • 1997-1999
    • Alfried Krupp Krankenhaus
      Essen, Lower Saxony, Germany
  • 1990-1999
    • Friedrich-Alexander Universität Erlangen-Nürnberg
      • Department of Surgery
      Erlangen, Bavaria, Germany
    • Ottawa Regional Cancer Foundation
      Ottawa, Ontario, Canada
  • 1990-1998
    • Universitätsklinikum Erlangen
      • Department of Surgery
      Erlangen, Bavaria, Germany
  • 1995
    • Freie Universität Berlin
      Berlín, Berlin, Germany