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DOI: 10.1055/a-2322-4087
Therapie des Ösophaguskarzinom
Das Ösophaguskarzinom weist trotz multimodaler Therapieansätze weiterhin nur geringe 5-Jahres-Überlebensraten von 15–25% auf. Angelehnt an die im Dezember 2023 publizierte 4. Version der 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. Die Immuncheckpoint-Inhibitor-Therapie nimmt hier einen immer größeren Stellenwert ein.
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Die chirurgische Resektion erfolgt abhängig von der Lokalisation des Tumors. Die Ösophagektomie sollte minimalinvasiv oder in Kombination mit offenen Verfahren (Hybrid-Technik) ausgeführt werden.
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Eine chirurgische Resektion ist bei präoperativ bekannter Oligometastasierung zurzeit nur im Rahmen von Studien indiziert (RENAISSANCE-Trial).
Schlüsselwörter
oberer Gastrointestinaltrakt - Onkologie - Chemotherapie - Radiotherapie - maligne ErkrankungPublication History
Article published online:
24 September 2024
© 2024. Thieme. All rights reserved.
Georg Thieme Verlag KG
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