Speicheldrüsentumoren: Limitationen der internationalen Guidelines und Bearbeitungsstand der AWMF-S3-Leitlinie

Primäre Speicheldrüsenkarzinome sind eher seltene Kopf-Hals-Tumoren, und man unterscheidet viele histologische Typen. Klinisch lassen sich maligne Tumoren oft nicht von benignen unterscheiden, sodass dies dann erst durch die histopathologische Diagnose möglich ist. Die wichtigsten internationalen Leitlinien zur Versorgung von Speicheldrüsentumoren sowie der aktuelle Stand der ersten deutschen S3-Leitlinie zu diesem Thema werden hier vorgestellt.

Abstract

Primary salivary gland carcinomas are not among the common head and neck tumors. They are characterized by manifold different histological types. Clinically, malignant tumors often cannot be distinguished from benign tumors, so that in these cases malignancy is only established by histopathological diagnosis. These are all reasons why there are relatively few clinical trials on the diagnosis, therapy and follow-up of these tumors. This in turn has the consequence that often only recommendations with limited evidence can be made in clinical guidelines. The most important international guidelines are the National Comprehensive Cancer Network (NCCN) guideline of 2023, the American Society of Clinical Oncology (ASCO) guideline of 2021, the European Society for Medical Oncology (ESMO) guideline of 2022 and still the British National Multidisciplinary guideline of 2016. These 4 international guidelines with their strengths and limitations are presented and commented here. Against this background, the development of a first German S3 clinical guideline on salivary gland tumors is important and expected to be completed in 2023. For the first time in the German guideline program on oncology, benign and malignant tumors are presented together in order to comprehensively do justice to the special features of salivary gland tumors.

Kernaussagen

• Bislang können wir uns bei der Behandlung von Speicheldrüsentumoren nur an wenigen internationalen Leitlinien orientieren, deren Empfehlungen häufig kein hohes Evidenzniveau erreichen.

• Die deutsche S3-Leitlinie zu Speicheldrüsentumoren ist bald fertiggestellt und wird die Evidenz der Diagnostik, Therapie und Nachsorge auf hohem methodischem Niveau abbilden.

• Die dargestellten internationalen Guidelines und auch bald die deutsche Leitlinie machen aber auch klar, dass in vielen Bereichen der Behandlung gezielte klinische Studien notwendig sind, um bessere Therapieempfehlungen treffen zu können.

Schlüsselwörter

Speicheldrüsen - Leitlinie - Tumor - Glandula parotis - Glandula submandibularis - Glandula sublingualis - kleine Speicheldrüsen - Diagnostik - Therapie - Chirurgie - Radiotherapie - Nachsorge

Keywords

Salivary glands - guideline - tumor - parotid gland - submandibular gland - sublingual gland - minor salivary glands - diagnosis - therapy - surgery - radiotherapy - aftercare

Publication History

Article published online:
06 February 2024

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