O Ortmann

Universität Regensburg, Ratisbon, Bavaria, Germany

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Publications (504)936.18 Total impact


  • No preview · Article · Feb 2016 · Geburtshilfe und Frauenheilkunde
  • Christina Selgrad · Olaf Ortmann
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    ABSTRACT: Background Selective progesterone receptor modulators (SPRM) are a group of substances with a multitude of potential applications in the field of gynecological endocrinology. Material and methods The state of knowledge on the mechanisms of action of SPRMs is summarized based on the currently available literature. In addition, the possible indications are discussed. Results The effects of progesterone are mediated by progesterone receptors (PR) and SPRMs have agonistic as well as antagonistic effects on the isoforms of PR. The isoforms primarily function as ligand-activated transcription factors. Possible indications are contraception, postcoital contraception, endometriosis therapy and treatment of uterine leiomyomas. Currently approved for clinical use are ulipristal acetate (UPA) and mifepristone (MFP), which can be prescribed as an effective postcoital contraceptive but the exact mechanism of action is not yet fully clarified. Additionally, UPA is a therapy option for premenopausal women with symptomatic uterine leiomyomas. There has been relatively little progress in the development of SPRMs for contraception. So far the amount of data currently available on the indications in the sense of long-term contraception are scarce. Conclusion The main fields of application of SPRMs are postcoital contraception and preoperative treatment of uterine leiomyomas. Future research efforts concerning the use of SPRMs are currently centered on the field of long-term contraception. Of particular interest is the vaginal ring delivery of UPA.
    No preview · Article · Jan 2016 · Gynäkologische Endokrinologie
  • Maximilian Mögele · Stefan Buchholz · Olaf Ortmann

    No preview · Article · Oct 2015 · Frauenheilkunde up2date
  • Susanne Schüler-Toprak · Olaf Ortmann

    No preview · Article · Oct 2015 · Frauenheilkunde up2date
  • O Ortmann · J Torode · U Helbig
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    ABSTRACT: Purpose: It is widely accepted that National Cancer Control Plans (NCCPs) are essential to improve cancer care. They often describe the structural requirements such as cancer centers, clinical cancer registries and quality control. During the 2nd European roundtable meeting, the implementation processes were analyzed and discussed. Results: Communication strategies between cancer registries and cancer centers need to be developed. Analyses and discussion of collected data have to be performed by multidisciplinary teams. This has to be followed by appropriate actions to improve quality of care. It is essential to describe the clinical procedures, organizational processes and communication between individuals and professional teams. The patients' perspectives have to be included in the development of cancer care networks. The patients' feedback on cancer care is a routine quality indicator. Conclusion: NCCPs that include the description of structural requirements are important. In addition, it is essential to develop cancer care networks including multidisciplinary organizational processes to guarantee high quality. These have to consider patients preferences.
    No preview · Article · Oct 2015 · Journal of Cancer Research and Clinical Oncology
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    ABSTRACT: The human genes coding for estrogen receptor alpha (ERα) and progesterone receptor (PR) express multiple receptor splice variants. Some of these receptor variants previously have been shown to exert distinct functions in cancer cells and might therefore differentially affect individual prognosis or therapy response. To examine the role of ERα- and PR-isoforms in endometrial cancer, we compared the expression of 19 ERα transcripts and 15 PR mRNA isoforms in human endometrium and in endometrioid endometrial cancer. Expression of seven ERα splice variants, total PR and of five PR transcript isoforms was found to be significantly decreased in endometrial cancer. In endometrioid G3 tumors, expression of 17 ERα and 10 PR splice variants was reduced when compared to normal tissue. Notably, only 13% of G3 tumors did not express any ERα variant and only in 25% of G3 samples no PR transcripts were expressed. Seven splice variants were preferentially expressed in G1 and G2 tumors. In G1 tumors, a higher number of different ERα and PR splice variants was expressed than in normal endometrium, G2 or G3 tumors. Expression of total PR and of single PR splice variants was found to be positively associated with PTEN. Our results encourage further studies to elucidate to what extent the heterogeneous co-expression profiles we found in endometrial cancer patients differentially affect both individual prognosis and therapy response.
    No preview · Article · Oct 2015 · Steroids
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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.
    Full-text · Article · Sep 2015 · Breast Cancer Research and Treatment
  • Olaf Ortmann

    No preview · Article · Sep 2015 · Der Gynäkologe
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    Olaf Ortmann

    Preview · Article · Aug 2015 · Archives of Gynecology
  • S. Freifrau von Welser · O. Ortmann · S. Seitz
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    ABSTRACT: Background: A central topic in physician-patient consultations deals with the communication of risks. The comprehensible communication of frequencies of desired and undesired events enables the patient to make a decision for or against a therapy and the weighing up of alternative treatment options. This requires the physician to give a clear communication of statistical data on the incidence and severity of side effects that must be weighed against the therapeutic goals and risk of failure. Objectives: This article presents and explains the basic principles of successful risk communication for surgical interventions using the example of hysterectomy for benign diseases. Methods: A literature search (Medline, Cochrane library) and an evaluation of current publications and guidelines on risk communication (published by the AGO, ACOG and AWMF) were carried out using the example of hysterectomy for benign diseases. Results: A total of 142,385 hysterectomies were carried out in Germany in 2007 of which 129,430 were due to a benign disease. Intraoperative complications occurred in 1.6 % of cases independent of the procedure and postoperative complications occurred in 6 % of cases. Regarding complications a significant advantage of the laparoscopic approach is confirmed, even in women after previous surgery. Out of 154,882 women 12 % underwent a second operation because of pelvic organ prolapse within 32 years after hysterectomy. Evidence of disorders of psychological well-being or sexual feelings could not be confirmed. All hysterectomy procedures for bleeding disorders and/or symptomatic uterine fibroids led to a significant improvement in the quality of life. Conclusion: Databases and guidelines provide an overview and an aid to interpretation based on the available data. Basic statistical knowledge is necessary for a correct interpretation and to avoid numerical manipulation. Training programs for doctors can help to improve the assessment of risks and thereby optimize the communication of the risks involved. This in turn is a prerequisite for successful treatment.
    No preview · Article · Aug 2015
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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.
    Full-text · Article · Aug 2015 · Journal of Cancer Research and Clinical Oncology
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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.
    Full-text · Article · Jul 2015 · European Journal of Clinical Microbiology
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    O. Ortmann · W. Jonat

    Preview · Article · Jul 2015 · Der Gynäkologe
  • M Ponnath · J Christ · D Günther · O Ortmann · U Germer

    No preview · Article · Jul 2015 · Geburtshilfe und Frauenheilkunde

  • No preview · Article · Jul 2015 · Geburtshilfe und Frauenheilkunde
  • O. Ortmann · U. Lang · S. Seitz

    No preview · Article · Jul 2015 · Geburtshilfe und Frauenheilkunde
  • S Schüler · C Lattrich · J Häring · O Treeck · O Ortmann

    No preview · Article · Jul 2015 · Geburtshilfe und Frauenheilkunde
  • E.C. Inwald · C. Lattrich · O. Ortmann
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    ABSTRACT: Background: Hormone therapy (HT) in perimenopause and postmenopause is one of the most frequently prescribed pharmacotherapies. Objective: Clear indication are an essential precondition for the use of HT. The dosage should be as low as possible and the period of therapy should be as short as possible. Prior to initiation of HT a detailed risk communication and benefit-risk analysis is necessary. Conclusion: Risk communication is a mandatory requirement for shared decision making. According to this both the physician and the patient come to a joint decision for or against therapy; therefore, complex professional information has to be conveyed to the patient in a comprehensible way.
    No preview · Article · Jun 2015

  • No preview · Article · May 2015 · Senologie - Zeitschrift für Mammadiagnostik und -therapie
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    Full-text · Conference Paper · May 2015

Publication Stats

5k Citations
936.18 Total Impact Points

Institutions

  • 2003-2015
    • Universität Regensburg
      • Department of Gynecology and Obstetrics
      Ratisbon, Bavaria, Germany
  • 2009-2014
    • University Hospital Regensburg
      • Institut für Pathologie
      Ratisbon, Bavaria, Germany
    • St. Josef-Hospital
      Bonn, North Rhine-Westphalia, Germany
  • 2005-2014
    • Caritas-Krankenhaus St. Josef
      Ratisbon, Bavaria, Germany
  • 2011
    • University of Texas MD Anderson Cancer Center
      • Department of Molecular Pathology
      Houston, TX, United States
  • 2008
    • St. Joseph Krankenhaus
      Berlín, Berlin, Germany
  • 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
  • 1989
    • National Institute of Child Health and Human Development
      Maryland, United States
  • 1988
    • National Institutes of Health
      • Section on Reproductive Endocrinology
      베서스다, Maryland, United States