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Handchir Mikrochir Plast Chir 2015; 47(02): 76-82
DOI: 10.1055/s-0034-1398527
Übersichtsarbeit
© Georg Thieme Verlag KG Stuttgart · New York

Sarkome an Hand und Handgelenk

Sarcoma of the Hand and Wrist
H. U. Steinau
1   Klinik für Allgemein-, Viszeral- und Transplantationschirurgie, Sektion Sarkomchirurgie, Westdeutsches Tumorzentrum CCC, Universitätsklinikum Essen, Universität Duisburg-Essen
,
F. Farzaliyev
1   Klinik für Allgemein-, Viszeral- und Transplantationschirurgie, Sektion Sarkomchirurgie, Westdeutsches Tumorzentrum CCC, Universitätsklinikum Essen, Universität Duisburg-Essen
,
I. Stricker
2   Institut für Pathologie der Ruhr-Universität Bochum, UK-Bergmannsheil RUB, Bochum
,
J. Hauser
3   Plastische Chirurgie, Alfried Krupp Krankenhaus Steele, Essen
,
L. E. Podleska
1   Klinik für Allgemein-, Viszeral- und Transplantationschirurgie, Sektion Sarkomchirurgie, Westdeutsches Tumorzentrum CCC, Universitätsklinikum Essen, Universität Duisburg-Essen
› Author Affiliations
Further Information

Publication History

eingereicht 18 November 2014

akzeptiert 15 December 2014

Publication Date:
11 March 2015 (online)

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Zusammenfassung

Sarkome an Hand und Handgelenk gelten als seltene Tumorentität, die in High Volume Krebszentren multidisziplinär behandelt werden sollten. Das Tumorboard entwickelt dabei Patienten orientierte Therapieoptionen, die sowohl den onkologischen Bereich als auch spezialisierte Hand- und plastisch-chirurgische Operationen einschließen. Zusätzlich kommt heute die isolierte Extremitätenperfusion mit TNF-alpha und Melphalan zum Einsatz, die eine präoperative Tumorreduktion mit nachfolgender R0 Resektion in Sano ermöglicht. Unsere klinischen Ergebnisse zeigen nach Risiko adaptiertem interdisziplinärem Vorgehen verringerte Amputationsraten und die Erhaltung nützlicher Handfunktionen für Langzeit-Überlebende.

Abstract

Sarcomas of the hand and wrist are rare malignancies, which should be referred to high-volume comprehensive cancer centres providing multidisciplinary treatment options. The tumour board should propose patient-oriented oncological pathways as well as sophisticated hand and plastic reconstructive procedures. In Addition, isolated limb perfusion with TNF-alpha and melphalan is likely to lead to preoperative tumour shrinkage allowing for R0 resection in sano. Our clinical results in long-term survivors demonstrate reduced amputation rates and salvage of basic hand function when a risk-adapted treatment rationale is applied.

Schlüsselwörter

Tumor  - Amputation  - Sarkome - Hand und Handgelenk - plastische Rekonstruktionen

Key words

Tumour  - amputation - sarcoma - hand and wrist - plastic reconstruction
 

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