Präventive Magenchirurgie bei hereditärem Magenkarzinom und genetischer Prädisposition

Zusammenfassung

Das hereditäre diffuse Magenkarzinom (HDGC) infolge krankheitsverursachender Varianten in CDH1 oder CTNNA1 sowie die familiäre adenomatöse Polyposis (FAP, krankheitsverursachende Varianten in APC) erfordern individuelle Strategien zur Krebsprävention. Beim HDGC wird eine prophylaktische totale Gastrektomie empfohlen, während bei FAP-Patienten die endoskopische Überwachung mit Interventionen im Vordergrund steht. Die Wahl der Rekonstruktion (Roux-en-Y, Jejunuminterposition, Double-Tract) beeinflusst sowohl die Möglichkeit zur endoskopischen Überwachung des Duodenums als auch die Lebensqualität. Entscheidungen über Überwachung vs. Operation sollten patientenbezogen unter Abwägung von Krebsrisiko und postoperativer Lebensqualität erfolgen.

Abstract

Hereditary diffuse gastric cancer (HDGC) caused by disease-causing variant in CDH1 or CTNNA1 and familial adenomatous polyposis (FAP, disease-causing variants in APC) require individualised cancer prevention strategies. In HDGC, prophylactic total gastrectomy is often recommended, whereas in FAP, endoscopic surveillance with interventions plays a central role. The choice of reconstruction (Roux-en-Y, jejunal interposition, double-tract) affects both duodenal accessibility and quality of life. Decisions between surveillance and surgery should be made individually, balancing cancer risk and postoperative quality of life.

Schlüsselwörter

Magenkarzinom - prophylaktische Gastrektomie - hereditäres Magenkarzinom - FAP - CDH1

Keywords

gastric cancer - preventive gastrectomy - hereditary gastric cancer - FAP - CDH1

Publication History

Received: 22 September 2025

Accepted: 23 October 2025

Article published online:
26 November 2025

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