Anatomische Lungenresektion nach neoadjuvanter Chemo-Immuntherapie: technische Aspekte und klinische Fallbeispiele

Zusammenfassung

Die Behandlungsmöglichkeiten des operablen Lungenkarzinoms haben sich seit der Zulassung der neoadjuvanten Chemo-Immuntherapie auch in der klinischen Routine wesentlich verbessert. Zentraler Bestandteil des neuen multimodalen Behandlungskonzeptes bleibt die operative Entfernung des Primärtumors durch anatomische Lungenresektion. Bei zunehmendem Einsatz der neuen Behandlungskonzepte in der klinischen Routine stellen sich aber auch kritische Fragen bez. der Sicherheit, möglicher Nebenwirkungen und der technischen Operabilität nach neoadjuvanter Chemo-Immuntherapie. Die Übersichtsarbeit fasst die aktuelle Datenlage zur perioperativen Sicherheit nach neoadjuvanter Chemo-Immuntherapie zusammen und erörtert besondere Aspekte der Operationstechnik, des Resektionsausmaßes und möglicher intraoperativer Besonderheiten anhand eigener klinische Fallbeispiele.

Abstract

Since the approval of neoadjuvant chemo-immunotherapy in Europe, treatment options for resectable stage II–III NSCLC have also significantly improved in clinical routine. Surgical excision of the tumour by anatomic lung resection still remains the most essential component of multimodal therapy. However, with the increasing use of the new treatment concepts in clinical routine, questions also arise regarding safety, adverse events and technical resectability following neoadjuvant chemo-immunotherapy. This review summarises the current data on perioperative safety following neoadjuvant chemo-immunotherapy and discusses aspects of surgical technique, the extent of resection and intraoperative challenges illustrated by clinical case reports.

Schlüsselwörter

Lungenkarzinom - neoadjuvante Therapie - Immuntherapie - Chemoimmuntherapie

Keywords

lung cancer - neoadjuvant - immuntherapy - chemoimmuntherapy

Publication History

Received: 05 May 2024

Accepted after revision: 17 June 2024

Article published online:
13 August 2024

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