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Dtsch Med Wochenschr 2014; 139(11): 538-542
DOI: 10.1055/s-0033-1360099
Übersicht | Review article
Pneumologie Thoraxchirurgie
© Georg Thieme Verlag KG Stuttgart · New York

Potenziell kurative chirurgische Therapie beim oligometastasierten nicht-kleinzelligen Lungenkarzinom

Potentially curative surgical therapy in oligometastatic non-small cell lung cancer
T. Plönes
1   Klinik für Thoraxchirurgie, Lungenklinik Köln-Merheim, Klinikum der Universität Witten/Herdecke, Campus Köln
,
S. Dango
2   Klinik für Allgemein und Viszeralchirurgie, Universitätklinikum Göttingen
,
W. Brugger
3   Schwarzwald-Baar Klinikum, Akademisches Lehrkrankenhaus der Universität Freiburg, Villingen-Schwenningen
,
C. Ludwig
1   Klinik für Thoraxchirurgie, Lungenklinik Köln-Merheim, Klinikum der Universität Witten/Herdecke, Campus Köln
,
E. Stoelben
1   Klinik für Thoraxchirurgie, Lungenklinik Köln-Merheim, Klinikum der Universität Witten/Herdecke, Campus Köln
› Author Affiliations
Further Information

Publication History

16 August 2013

31 October 2013

Publication Date:
04 March 2014 (online)

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Zusammenfassung

Das nicht-kleinzellige Lungenkarzinom ist eine der häufigsten Krebserkrankungen weltweit und damit auch eine der häufigsten krebsbedingten Todesursachen. Bei Erstdiagnose haben bereits rund 40 % aller Patienten Fernmetastasen (Tumorstadium UICC IV) und werden mit einer palliativen systemischen Chemotherapie und/oder Tyrosinkinase-Inhibition behandelt. Eine kleine Gruppe dieser Patienten weist jedoch nur eine einzige Fernmetastase auf. Diese kann synchron oder erst metachron auftreten und intrathorakal oder extrathorakal liegen. Im Gegensatz zu multiplen Metastasen, die Ausdruck einer diffusen systemischen Erkrankung sind und dementsprechend einer systemischen Therapie bedürfen, kann man das Auftreten singulärer Metastasen als noch begrenzte Erkrankung auffassen. Durch lokale Exzision der Metastasen und des Primärtumors haben die Patienten eine Chance auf Heilung. Eine Resektion des Primärtumors und der singulären Metastase kann die Überlebenswahrscheinlichkeit in vielen Fällen deutlich verbessern.

Abstract

Lung cancer is a leading cause of cancer related death worldwide. Non-small cell lung cancer (NSCLC) represents 85 % of all lung cancer cases and approximately 40 % of all patients impress with a metastatic disease at the time of diagnosis. Stage IV NSCLC has a poor prognosis and is incurable. The recommended standard therapy in this case is a palliative supportive systemic chemotherapy. However, a distinctive subgroup of patients with stage IV NSCLC appear clinically with an oligometastatic disease and may qualify for surgical therapy. There is evidence that patients with synchronous or metachronus solitary satellite nodules, either located intrapulmonary or extrapulmonary, benefit from surgical resection.

Schlüsselwörter

nicht-kleinzelliges Lungenkarzinom Stadium IV - NSCLC - singuläre Metastase - Resektion

Keywords

non-small cell lung cancer stage IV - NSCLC - single metastasis - resection
 

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