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Erschienen in:

21.01.2024 | Mesotheliom | Topic

Peritoneales Mesotheliom und Pseudomyxoma peritonei

verfasst von: Safak Gül, Matylda Zofia Kuzinska, Timo A. Auer, Christian Oberender, Miguel Enrique Alberto Vilchez, Wolf-Rüdiger Ramackers, Marianne Sinn, Prof. Dr. med. Beate Rau, MBA

Erschienen in: best practice onkologie | Ausgabe 1-2/2024

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Zusammenfassung

Hintergrund

Das peritoneale Mesotheliom und das Pseudomyxoma peritonei (PMP) sind seltene primäre bösartige Erkrankungen des Peritoneums. Bis zur kombinierten Anwendung der zytoreduktiven Chirurgie (CRS) und hyperthermen intraperitonealen Chemotherapie (HIPEC), die eine kurative Therapieoption für diese beiden Erkrankungen sein kann, galten sie lange als unheilbar und wurden primär palliativ behandelt. Die Kombinationstherapie aus CRS-HIPEC, die in spezialisierten Zentren für Peritonealkarzinose angewandt wird, stellt einen fundamentalen Bestandteil der Behandlungsmethode dar und kann das Überleben deutlich verbessern, wenn die Vollständigkeit der Zytoreduktion (CC-Score, „completeness of cytoreduction“) gegeben ist.

Methoden

Für die vorliegende Arbeit wurde eine Übersicht erstellt, die aktuelle Literatur zur Inzidenz, Prognose, Staging und systemischen Therapieoptionen enthält sowie zu bisher durchgeführten Studien zur CRS und HIPEC bei peritonealem Mesotheliom und PMP einen Überblick gibt.

Ergebnisse

Die CRS-HIPEC kann das Überleben beim peritonealen Mesotheliom und PMP deutlich verbessern, wobei die individuelle Prognose in Abhängigkeit von der Histopathologie variieren kann. Spezifische Algorithmen und Scoring-Systeme werden in der radiologischen Diagnostik und bei chirurgischen Eingriffen zur Unterstützung der Prognosebeurteilung eingesetzt. Die angewandten HIPEC-Schemata sind von der Monotherapie bis zur Dualtherapie sowie hinsichtlich der zeitlichen Dauer sehr heterogen. Eine komplikationslose CRS-HIPEC kann zu sehr guten Überlebensraten führen. Besteht jedoch keine vernünftige Operabilität, ist die systemische medikamentöse onkologische Therapie eine Alternative, die mit der palliativen CRS-HIPEC kombiniert werden kann.

Schlussfolgerung

Die Behandlung vom peritonealen Mesotheliom und PMP erfordert angesichts ihrer Komplexität eine Behandlung in einem spezialisierten Zentrum und eine interdisziplinäre Zusammenarbeit. Unter Anwendung standardisierter Operationsabläufe („standard operating procedure“, SOP) können sehr gute Ergebnisse erzielt werden. Randomisierte kontrollierte Studien zu verschiedenen HIPEC-Schemata sind erforderlich.

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Titel: Peritoneales Mesotheliom und Pseudomyxoma peritonei
verfasst von: Safak Gül
Matylda Zofia Kuzinska
Timo A. Auer
Christian Oberender
Miguel Enrique Alberto Vilchez
Wolf-Rüdiger Ramackers
Marianne Sinn
Prof. Dr. med. Beate Rau, MBA
Publikationsdatum: 21.01.2024
Verlag: Springer Medizin
Schlagwörter: Mesotheliom
Zytostatische Therapie
Peritonealkarzinose
Peritonealkarzinose
Erschienen in: best practice onkologie / Ausgabe 1-2/2024
Print ISSN: 0946-4565
Elektronische ISSN: 1862-8559
DOI: https://doi.org/10.1007/s11654-023-00548-y

Springer Medizin

Peritoneales Mesotheliom und Pseudomyxoma peritonei

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Neu im Fachgebiet Onkologie

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Update Onkologie

Springer Medizin

Zusammenfassung

Hintergrund

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Ergebnisse

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