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DOI: 10.1055/s-0043-113906
Ösophaguskarzinom Update
Publication History
Publication Date:
05 October 2017 (online)
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Das Ösophaguskarzinom weist trotz multimodaler Therapieansätze weiterhin nur geringe 5-Jahres-Überlebensraten von 15 – 25% auf. Angelehnt an die im Jahr 2015 publizierte S3-Leitlinie sowie die „ESMO Clinical Practice Guidelines“ stellen wir in diesem Artikel Diagnostik, Staging und Therapie der Plattenepithelkarzinome und Adenokarzinome des Ösophagus dar.
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Die Diagnostik erfolgt durch Ösophagogastroduodenoskopie mit Biopsien.
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Für das Staging sind Endosonografie und Computertomografie notwendig.
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Bei Frühkarzinomen (T1a; ggf. T1b bei Adenokarzinomen) kann eine endoskopische Resektion versucht werden.
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Bei lokal fortgeschrittenen Karzinomen (T3–4 oder N+) ist eine multimodale Therapie indiziert.
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Die chirurgische Resektion erfolgt abhängig von der Lokalisation des Tumors:
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Ivor Lewis,
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McKeown,
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zervikale Resektion oder
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transhiatal erweiterte Gastrektomie.
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Eine chirurgische Resektion ist bei Oligometastasierung zurzeit nur im Rahmen von Studien indiziert (RENAISSANCE Trial)
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Literatur
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