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Chirurgische Therapie pulmonaler Metastasen von Kopf-Hals-Tumoren

Surgical therapy of lung metastases from head and neck cancer

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Zusammenfassung

Die Lungenmetastasenchirurgie ist ein etabliertes Verfahren in onkologischen Therapiekonzepten. Eine systematische Literaturrecherche und Analyse aller Studien, die ab dem 01.01.2000 publiziert worden sind, soll ihren Nutzen für Patienten mit primären Kopf-Hals-Tumoren (KHT) evaluieren. 1,9-13% aller Patienten mit KHT entwickeln Lungenmetastasen. Die Patienten erreichen nach der Metastasektomie 5-Jahres-Überlebensraten bis zu 58 % und ein medianes Überleben zwischen 9,5 und 78 Monaten. Die Raten für intrathorakale Rezidive betragen 18,4–81,8 %. Diese Patienten können sich im Einzelfall einer Remetastasektomie unterziehen. Patienten mit Plattenepithelkarzinomen haben die ungünstigste Prognose, können aber ein Langzeitüberleben (≥ 60 Monate) erreichen. Die Lungenmetastasenchirurgie stellt häufig den einzigen potenziell kurativen Ansatz dar und ermöglicht ein günstigeres Langzeitüberleben als nichtchirurgische Therapieformen. Sie sollte daher die Therapie der ersten Wahl für diese Patienten sein.

Abstract

Pulmonary metastasectomy is an established procedure in oncological therapeutic concepts. A systematic literature search and an analysis of all studies published since 01.01.2000 should evaluate the advantage of pulmonary metastasectomy for patients with primary head and neck cancer. Lung metastases develop in 1.9–13 % of head and neck cancer patients. Following metastasectomy, patients reach a median survival of 9.5–78 months and 5-year survival rates of up to 58 % are achieved. Intrathoracic recurrence occurs in 18.4–81.8 % of patients, selected instances of which can be successfully treated by remetastasectomy. Patients with squamous cell carcinoma have the worst prognosis, but could also become long-term survivors (≥ 60 months). Pulmonary metastasectomy is frequently the only potentially curative therapeutic approach and offers a better long-term survival than nonsurgical therapies. Lung metastasectomy is thus the treatment of choice in selected patients with pulmonary metastases from primary head and neck cancer.

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Einhaltung ethischer Richtlinien

Interessenkonflikt. K. Hekmat, S. Macherey, S.F. Preuss,·F. Doerr, S. Grönke, M. Heldwein und A. Quaas geben an, dass kein Interessenkonflikt besteht. T. Zander hat persönliche Gelder von Roche, Merck, Novartis, Amgen, Abbvie, Pfizer erhalten (Vorträge) – jedoch nicht im Zusammenhang mit der aktuellen Arbeit. Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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Authors and Affiliations

  1. Medizinische Fakultät, Universität zu Köln, Köln, Deutschland

    S. Macherey & F. Doerr

  2. Klinik und Poliklinik für Hals-, Nasen- und Ohrenheilkunde, Universität zu Köln, Köln, Deutschland

    S.F. Preuss

  3. Klinik und Poliklinik für Kardiologie und Pneumologie, Universität zu Köln, Köln, Deutschland

    S. Grönke

  4. Klinik und Poliklinik für Herz- und Thoraxchirurgie, Universität zu Köln, Kerpener Str. 62, 50931, Köln, Deutschland

    M. Heldwein &  K. Hekmat

  5. Institut für Pathologie und Neuropathologie, Universität zu Köln, Köln, Deutschland

    A. Quaas

  6. Klinik und Poliklinik für Hämatoonkologie, Universität zu Köln, Köln, Deutschland

    T. Zander

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  1. S. Macherey
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  2. S.F. Preuss
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  3. F. Doerr
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Correspondence to K. Hekmat.

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Macherey, S., Preuss, S., Doerr, F. et al. Chirurgische Therapie pulmonaler Metastasen von Kopf-Hals-Tumoren. HNO 62, 893–904 (2014). https://doi.org/10.1007/s00106-014-2933-2

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  • DOI: https://doi.org/10.1007/s00106-014-2933-2

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