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DOI: 10.1055/s-0033-1360338
Wie radikal sollte ein Magen- bzw. Kardiakarzinom operiert werden?
How Radical Should the Surgical Therapy for Gastric/Cardia Cancer Be?Publikationsverlauf
Publikationsdatum:
28. Februar 2014 (online)
Zusammenfassung
Mit Ausnahme von Mukosakarzinomen ist die chirurgische Entfernung des Primärtumors und seiner regionalen Lymphknotenmetastasen nach wie vor die einzige Option zur kurativen Therapie des potenziell resezierbaren Magenkarzinoms, sofern eine komplette Resektion ohne Residualtumor (R0-Resektion) erreicht werden kann. Dabei wurde in den letzten Jahren das Ausmaß der chirurgischen Radikalität vor allem unter folgenden Aspekten diskutiert: 1. Ausmaß der Lymphadenektomie/Notwendigkeit der Splenektomie; 2. subtotale vs. totale Gastrektomie; 3. chirurgische Therapie beim Kardiakarzinom; 4. operatives Vorgehen bei cT4-Karzinomen; 5. laparoskopische vs. offene Resektionsverfahren. Diese Übersichtsarbeit soll, basierend auf der aktuellen Studienlage sowie den gegenwärtigen Leitlinien, die aufgeführten Punkte diskutieren und einen Einblick in die empfohlene chirurgische Radikalität beim Magenkarzinom geben.
Abstract
With the exception of tumours limited to the mucosa, surgical resection of the primary tumour and its local lymph node metastases still remains the sole option for a curative therapy for potentially resectable gastric cancer, as long as a complete tumour resection (R0 resection) can be performed. In this context, the extent of surgical radicality has been discussed over the last years, especially based on the following aspects: 1. extent of lymphadenectomy/need for splenectomy; 2. subtotal versus total gastrectomy; 3. surgical therapy for cardia cancer; 4. operative approach in cT4-tumours; 5. laparoscopic versus open surgery. Based on the recent study results as well as the current guidelines, this review will discuss these specific issues and gives an insight about the recommended surgical radicality in gastric cancer.
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