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Indikation von CRS und HIPEC beim peritoneal metastasierten Magenkarzinom

  • Chapter
Peritoneale Tumoren und Metastasen

  • 1639 Accesses

Zusammenfassung

Die Prognose des Magenkarzinoms wird mit der Aussaat von Tumorzellen in die Abdominalhöhle bzw. das Peritoneum deutlich verschlechtert. Unter der derzeitigen alleinigen systemischen Chemotherapie haben Magenkarzinompatienten mit peritonealer Metastasierung eine mediane Überlebenszeit von ungefähr 6–9 Monaten. Beim metastasierten Magenkarzinom werden verschiedene Therapieregime mit unterschiedlichem Erfolg diskutiert. Die Wahl der Therapieform – allein medikamentös, Kombination aus medikamentöser und/oder operativer Therapie – sowie die Wahl der Medikamente hängen sowohl von der Tumorentität als auch vom Peritonealkarzinose-Index (PCI) ab. Je höher er bei einigen Tumoren ist, umso weniger wahrscheinlich ist die Entfernung aller Tumorknoten im Rahmen einer operativen Therapie. Im Falle einer kompletten Tumorresektion und Entfernung der peritonealen Metastasen kann durch zusätzlich durchgeführte Spülung mit Chemotherapie der Bauchhöhle (hypertherme intraperitoneale Chemotherapie, HIPEC) für etwaig zurückgebliebene Tumorzellen eine deutliche Verzögerung des Tumorrückfalls bewirkt werden.

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  1. Charité Campus Virchow Klinikum, Klinik für Chirurgie, Charité CampusVirchow ­Klinikum, Charité – Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Deutschland

    Prof. Dr. med. B. Rau & E. Pachmayr

  2. Charité Universitätsmedizin Berlin, Campus Virchow-Klinikum, Medizinische Klinik m.S. Hämatologie, Onkologie und Tumorimmunologie, Augustenburger Platz 1, 13353, Berlin, Deutschland

    PD Dr. med. P. Thuss-Patience

  3. Charité Universitätsmedizin Berlin, Campus Mitte & Campus Virchow-Klinikum, Klinik für Allgemein-, Viszeral- und ­Transplantationschirurgie, Charité Platz 1, 10117, Berlin, Deutschland

    Dr. med. A. Brandl

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  1. Charité Campus Virchow-Klinikum, Berlin, Deutschland

    Beate Rau

  2. Krankenhaus Barmherzige Brüder, Regensburg, Deutschland

    Pompiliu Piso

  3. Universitätsklinikum Tübingen, Tübingen, Deutschland

    Alfred Königsrainer

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Rau, B., Pachmayr, E., Thuss-Patience, P., Brandl, A. (2018). Indikation von CRS und HIPEC beim peritoneal metastasierten Magenkarzinom. In: Rau, B., Piso, P., Königsrainer, A. (eds) Peritoneale Tumoren und Metastasen. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-54500-3_20

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