Das Adenokarzinom des Ösophagus – Bestandsaufnahme einer drastisch zunehmenden Erkrankung

Zusammenfassung

Das Adenokarzinom des Ösophagus ist eine der am stärksten zunehmenden Tumorentitäten in der westlichen Welt. Seine Inzidenz hat sich seit 1991 in Deutschland mehr als versiebenfacht. Die bedeutendsten Risikofaktoren stellen die gastroösophageale Refluxerkrankung und die Adipositas dar. Die endoskopische Resektion ist ein effektives Verfahren für die Diagnostik und die kurative Therapie der Frühkarzinome. Die Ösophagusresektion ist die zentrale kurative Therapiemodalität für mucosa-überschreitende und nicht-metastasierte Tumorstadien. Neoadjuvante radiochemotherapeutische und perioperativ chemotherapeutische Behandlungsprotokolle kommen zunehmend zum Einsatz. Die onkologische Prognose für lokal fortgeschrittene Tumorstadien konnte auf 5- Jahresüberlebensraten von 50 % verbessert werden.

Abstract

The incidence of esophageal adenocarcinoma is dramatically increasing in several Western countries. In Germany, the incidence increased by sevenfold since 1991. The most important risk factors for esophageal adenocarcinoma are gastroesophageal reflux and obesity. Early diagnosis is possible within surveillance programs for Barrett metaplasia. Endoscopic resection is effective for diagnosis and curative treatment of early carcinoma. Esophagectomy is the central curative treatment modality for non-metastasized tumors exceeding the mucosal layer. Both neoadjuvant chemoradiation and perioperative chemotherapy are increasingly applied. Long term prognosis for locally advanced tumors improved to nearly 50 % five year survival.

Schlüsselwörter

Ösophaguskarzinom - Adenokarzinom - Epidemiologie - Endoskopie - Chirurgie

Key words

esophageal cancer - adenocarcinoma - epidemiology - endoscopy - surgery

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