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Lege artis - Das Magazin zur ärztlichen Weiterbildung 2014; 4(2): 98-103
DOI: 10.1055/s-0034-1373817
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© Georg Thieme Verlag Stuttgart · New York

Peritonealkarzinose – Aktuelle Therapieansätze

Florian Struller
,
Philipp Horvath
,
Ingmar Königsrainer
,
Stefan Beckert
,
Alfred Königsrainer
Further Information

Publication History

Publication Date:
07 May 2014 (online)

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Zusammenfassung

Ein metastatischer Befall des Bauchfells (Peritonealkarzinose), wurde bis vor wenigen Jahren als terminales Krankheitsstadium angesehen. Durch das Konzept der maximalen Zytoreduktion (Peritonektomie) und hyperthermen intraperitonealen Chemotherapie (HIPEC) konnte das Überleben ausgewählter Patienten bei gleichzeitig stabiler Lebensqualität verbessert werden. Entscheidendes Selektionskriterium scheint das intraabdominelle Tumorvolumen zu sein, das anhand des Peritoneal Cancer Index (PCI) bereits präoperativ abgeschätzt werden kann. Obligat ist jedoch vor Einleitung einer derartigen Therapie die Vorstellung eines jeden Patienten in einer interdisziplinären Tumorkonferenz.

Kernaussagen

  • Die Peritonealkarzinose ist als eigenständige Tumorentität zu betrachten.

  • Der Peritoneal Cancer Index nach Sugarbaker ist wichtiges Selektionskriterium für die Behandlung.

  • Die Indikation zur HIPEC besteht nur bei makroskopischer Tumorfreiheit (CC 0–1).

  • Das geschlossene HIPEC-Verfahren ermöglicht einen geringeren Hitzeverlust.

  • Jeder Patient sollte in einem interdisziplinären Tumorboard an einem entsprechend zertfizierten Zentrum besprochen werden.

Schlüsselwörter

Peritonealkarzinose - Peritonektomie - HIPEC - Peritoneal Cancer Index - Completeness of Cytoreduction

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