Ösophaguskarzinome - aktueller Stand der Diagnostik und Therapie

Zusammenfassung

Ösophaguskarzinome kennzeichnen sich durch eine in den letzten 15 Jahren zunehmende Inzidenz bei fast gleichbleibend schlechter Prognose. Als therapeutisches Verfahren der Wahl gilt weiterhin die chirurgische Resektion mit ausgedehnter Lymphadenektomie, die mit einer nicht unerheblichen Anzahl peri- und postoperativer Komplikationen bei nur in wenigen Fällen erzielbarem Langzeitüberleben assoziiert ist. Für Tumorvor- und Tumorfrühstadien etablieren sich daher zunehmend lokale Therapieverfahren - wie beispielsweise Mukosektomien - mit viel versprechenden Ergebnissen. Auch in fortgeschrittenen Tumorstadien entwickeln sich Alternativen zum chirurgischen Vorgehen. So konnten mittels primärer Radiochemotherapie bereits äquivalente Überlebenszeiten wie bei primär chirurgisch therapierten Patienten demonstriert werden. Die Übersichtsarbeit beschreibt Epidemiologie, Ätiologie, Staging und die daraus resultierenden Therapiekonsequenzen für Ösophaguskarzinome unter aktuellen Gesichtspunkten.

Abstract

Esophageal carcinoma is characterized by an increasing incidence in the last 15 years whereas the prognosis still remains almost invariably poor. The therapy of choice is still deemed to be surgical resection including extended lymphadenectomy which is accompanied by considerable amounts of peri- and postoperative complications and only rare long-time survival. Precursor lesions and early stage cancers are therefore increasingly often treated by local ablative procedures including mucosectomy, which demonstrates promising results. In advanced tumor stages definitive chemoradiation provided long-term survival equivalent to that in contemporary surgical series and thus represents another alternative to tumor resection. This review points out the epidemiology, aetiology, staging and consequences in therapy for esophageal carcinoma considering current points of view.

Ösophaguskarzinom - Mukosektomie - primäre Radiochemotherapie

Esophageal carcinoma - mucosectomy - primary radiochemotherapy

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