Selektive Neck dissection bei Karzinomen der oberen Luft- und Speisewege

Zusammenfassung

Während früher die (modifiziert-) radikale Neck dissection als eine unverzichtbare Maßnahme für die Sicherstellung der regionalen Tumorkontrolle und Verbesserung der Gesamtprognose bei Kopf-Hals-Karzinomen verstanden wurde, wird dieses Verfahren heute zunehmend durch die selektive Neck dissection ersetzt. Eine selektive Neck dissection weist vergleichsweise eine geringere Morbidität und akzeptable funktionelle Ergebnisse auf, ohne dabei die Prognose der Patienten negativ zu beeinflussen. Die selektive Neck dissection stellt als Staging-Verfahren zurzeit unzweifelhaft den Goldstandard dar. Damit ist die selektive Neck dissection ein fester Bestandteil den Therapie des klinischen N0-Halses und wird als Salvage-Therapie des Halses nach Radiochemotherapie empfohlen. Es gibt auch Argumente für die Durchführung einer selektiven Neck dissection bei selektionierten Patienten mit N +  Hals.

Abstract

While (modified) radical neck dissection was seen formerly as an essential measure for securing local tumor control and improvement of the prognosis for head and neck cancer patients, this procedure is nowadays often replaced by selective neck dissection. Selective neck dissection is associated with a comparably low morbidity and acceptable functional results without having a negative impact on the prognosis of the patients. As staging procedure, neck dissection is currently the gold standard, so that selective neck dissection is an approved part of the therapy of the clinical N0 neck and is recommended as salvage therapy of the neck after radiochemotherapy. There are also aspects supporting the performance of selective neck dis­section in selected patients with N +  neck.

Schlüsselwörter

Neck dissection - selektiv - N0-Hals - N +  Hals - Prognose

Key words

neck dissection - selective - N0 neck - N +  neck - prognosis

• Literatur

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