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Erschienen in: Die Chirurgie 7/2022

17.06.2022 | Leberresektion | Leitthema

Lebermetastasen neuroendokriner Tumoren

verfasst von: Prof. Dr. S. Nadalin, M. Peters, A. Königsrainer

Erschienen in: Die Chirurgie | Ausgabe 7/2022

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Zusammenfassung

Neuroendokrine Lebermetastasen (NELM) sind in Bezug auf die klinische Präsentation und die Prognose sehr heterogen. Die Behandlung von NELM erfordert einen multidisziplinären Ansatz und Patienten mit NELM sollten an spezialisierte Zentren überwiesen werden. Die Resektion von NELM bietet, sofern durchführbar, die besten langfristigen Ergebnisse. Zu den allgemeinen Selektionskriterien für eine Leberresektion gehören ein für eine größere Leberoperation akzeptabler Allgemeinzustand, Tumoren mit günstiger Differenzierung Grad 1 oder 2, das Fehlen extrahepatischer Läsionen, ein suffizientes Restlebervolumen sowie die Möglichkeit, mindestens 70 % der Metastasen zu resezieren. Ergänzende Therapien, einschließlich der gleichzeitigen Leberablation, sind im Allgemeinen sicher und können die Zahl der für eine Operation infrage kommenden Patienten erhöhen. Bei Patienten mit resektablen NELM wird die Resektion des Primärtumors entweder in einem zweizeitigen oder kombinierten Verfahren empfohlen. Bei selektionierten Patienten mit irresektablen NELM kann eine Lebertransplantation erfolgen, welche mit exzellenten Langzeitergebnisse einhergehen kann.
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Metadaten
Titel
Lebermetastasen neuroendokriner Tumoren
verfasst von
Prof. Dr. S. Nadalin
M. Peters
A. Königsrainer
Publikationsdatum
17.06.2022
Verlag
Springer Medizin
Erschienen in
Die Chirurgie / Ausgabe 7/2022
Print ISSN: 2731-6971
Elektronische ISSN: 2731-698X
DOI
https://doi.org/10.1007/s00104-022-01656-1