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01.03.2005 | Update Onkologie

Metastasierte testikuläre Keimzelltumoren

Aktuelle Indikationen zur Residualtumorresektion nach induktiver Chemotherapie

verfasst von: Prof. Dr. A. Heidenreich, C. H. Ohlmann

Erschienen in: Die Onkologie | Ausgabe 3/2005

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Zusammenfassung

Die Resektion von Residualtumoren (RTR) nach induktiver cisplatinbasierter Chemotherapie ist integraler Bestandteil der multimodalen Therapie fortgeschrittener Keimzelltumoren. Ihre Zielsetzung bei Patienten mit negativen Tumormarkern muss die komplette, radikale Entfernung sämtlicher Tumormassen inklusive benachbarter Organstrukturen unter kurativer Intention sein. Entsprechend den aktuellen Leitlinien der European Germ Cell Cancer Consensus Group (EGCCCG) ist die Indikation zur RTR beim Seminom heute nur noch bei positivem PET-Befund 4–6 Wochen nach Abschluss einer Strahlen- oder Chemotherapie gegeben. Ansonsten kann auf sie verzichtet werden, wenn Primärdiagnostik und -therapie leitlinienkonform durchgeführt wurden. Beim markernegativen Residuum eines nichtseminomatösen Keimzelltumors erfolgt sie bei allen Patienten unabhängig von der Größe der Läsion. Patienten mit plateauartig erhöhten Markern werden ebenfalls einer RTR zugeführt. Bei Markerprogression nach oder unter Salvage-Therapie ist sie nur dann indiziert, wenn die Läsionen komplett resezierbar sind. Spätrezidive sollten der primären chirurgischen Resektion zugeführt werden. Letztendlich stellt die RTR eine sinnvolle therapeutische Option bei Patienten mit lokoregionärem Rezidiv bei bereits erfolgter RPLA dar, wenn die Läsionen komplett resektabel erscheinen.
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Metadaten
Titel
Metastasierte testikuläre Keimzelltumoren
Aktuelle Indikationen zur Residualtumorresektion nach induktiver Chemotherapie
verfasst von
Prof. Dr. A. Heidenreich
C. H. Ohlmann
Publikationsdatum
01.03.2005
Verlag
Springer-Verlag
Erschienen in
Die Onkologie / Ausgabe 3/2005
Print ISSN: 2731-7226
Elektronische ISSN: 2731-7234
DOI
https://doi.org/10.1007/s00761-005-0832-6

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