Skip to main content
Erschienen in: International Urology and Nephrology 1/2012

01.02.2012 | Urology – Review

Advanced penile cancer

verfasst von: Jonathan E. Heinlen, David D. Buethe, Daniel Joseph Culkin

Erschienen in: International Urology and Nephrology | Ausgabe 1/2012

Einloggen, um Zugang zu erhalten

Abstract

Penile cancer is an uncommon disease in the industrialized world that most frequently presents at low stage and is cured with treatment of local and regional surgery. In cases of advanced cancer, the use of more aggressive surgical techniques and the addition of adjuvant therapy may be warranted. So far, few agents have been found that improve survival with metastatic disease and thus aggressive primary treatment is required. This review discusses diagnosis, staging, and therapy for high risk penile cancer.
Literatur
1.
Zurück zum Zitat Pow-Sang MR et al (2010) Epidemiology and natural history of penile cancer. Urology 76(2 Suppl 1):S2–S6PubMedCrossRef Pow-Sang MR et al (2010) Epidemiology and natural history of penile cancer. Urology 76(2 Suppl 1):S2–S6PubMedCrossRef
2.
Zurück zum Zitat Soria JC et al (1997) Squamous cell carcinoma of the penis: multivariate analysis of prognostic factors and natural history in a monocentric study with a conservative policy. Ann Oncol 8(11):1089–1098PubMedCrossRef Soria JC et al (1997) Squamous cell carcinoma of the penis: multivariate analysis of prognostic factors and natural history in a monocentric study with a conservative policy. Ann Oncol 8(11):1089–1098PubMedCrossRef
3.
Zurück zum Zitat Tseng HF et al (2001) Risk factors for penile cancer: results of a population-based case-control study in Los Angeles County (US). Cancer Causes Control 12(3):267–277CrossRef Tseng HF et al (2001) Risk factors for penile cancer: results of a population-based case-control study in Los Angeles County (US). Cancer Causes Control 12(3):267–277CrossRef
4.
Zurück zum Zitat Maden C et al (1993) History of circumcision, medical conditions, and sexual-activity and risk of penile cancer. J Natl Cancer Inst 85(1):19–24PubMedCrossRef Maden C et al (1993) History of circumcision, medical conditions, and sexual-activity and risk of penile cancer. J Natl Cancer Inst 85(1):19–24PubMedCrossRef
5.
6.
Zurück zum Zitat Hungerhuber E et al (2006) Risk stratification in penile carcinoma: 25-year experience with surgical inguinal lymph node staging. Urology 68(3):621–625PubMedCrossRef Hungerhuber E et al (2006) Risk stratification in penile carcinoma: 25-year experience with surgical inguinal lymph node staging. Urology 68(3):621–625PubMedCrossRef
7.
Zurück zum Zitat Antunes AA, Dall’Oglio MF, Srougi M (2007) Organ-sparing treatment for penile cancer. Nat Clin Pract Urol 4(11):596–604PubMedCrossRef Antunes AA, Dall’Oglio MF, Srougi M (2007) Organ-sparing treatment for penile cancer. Nat Clin Pract Urol 4(11):596–604PubMedCrossRef
8.
Zurück zum Zitat Hardner GJ et al (1972) Carcinoma of the penis: analysis of therapy in 100 consecutive cases. J Urol 108(3):428–430PubMed Hardner GJ et al (1972) Carcinoma of the penis: analysis of therapy in 100 consecutive cases. J Urol 108(3):428–430PubMed
9.
Zurück zum Zitat Lont AP et al (2007) Pelvic lymph node dissection for penile carcinoma: extent of inguinal lymph node involvement as an indicator for pelvic lymph node involvement and survival. J Urol 177(3):947–952PubMedCrossRef Lont AP et al (2007) Pelvic lymph node dissection for penile carcinoma: extent of inguinal lymph node involvement as an indicator for pelvic lymph node involvement and survival. J Urol 177(3):947–952PubMedCrossRef
10.
11.
Zurück zum Zitat Haas GP et al (1999) Cisplatin, methotrexate and bleomycin for the treatment of carcinoma of the penis: a southwest oncology group study. J Urol 161(6):1823–1825PubMedCrossRef Haas GP et al (1999) Cisplatin, methotrexate and bleomycin for the treatment of carcinoma of the penis: a southwest oncology group study. J Urol 161(6):1823–1825PubMedCrossRef
12.
Zurück zum Zitat Srinivas V et al (1987) Penile cancer: relation of extent of nodal metastasis to survival. J Urol 137(5):880–882PubMed Srinivas V et al (1987) Penile cancer: relation of extent of nodal metastasis to survival. J Urol 137(5):880–882PubMed
13.
Zurück zum Zitat Ravi R (1993) Correlation between the extent of nodal involvement and survival following groin dissection for carcinoma of the penis. Br J Urol 72(5 Pt 2):817–819PubMedCrossRef Ravi R (1993) Correlation between the extent of nodal involvement and survival following groin dissection for carcinoma of the penis. Br J Urol 72(5 Pt 2):817–819PubMedCrossRef
14.
Zurück zum Zitat Ornellas AA et al (1994) Surgical treatment of invasive squamous cell carcinoma of the penis: retrospective analysis of 350 cases. J Urol 151(5):1244–1249PubMed Ornellas AA et al (1994) Surgical treatment of invasive squamous cell carcinoma of the penis: retrospective analysis of 350 cases. J Urol 151(5):1244–1249PubMed
15.
Zurück zum Zitat Scardino E et al (2004) Magnetic resonance imaging combined with artificial erection for local staging of penile cancer. Urology 63(6):1158–1162PubMedCrossRef Scardino E et al (2004) Magnetic resonance imaging combined with artificial erection for local staging of penile cancer. Urology 63(6):1158–1162PubMedCrossRef
16.
Zurück zum Zitat Hughes B et al (2009) Non-invasive and minimally invasive staging of regional lymph nodes in penile cancer. World J Urol 27(2):197–203PubMedCrossRef Hughes B et al (2009) Non-invasive and minimally invasive staging of regional lymph nodes in penile cancer. World J Urol 27(2):197–203PubMedCrossRef
17.
Zurück zum Zitat Scher B et al (2005) 18F-FDG PET/CT for staging of penile cancer. J Nucl Med 46(9):1460–1465PubMed Scher B et al (2005) 18F-FDG PET/CT for staging of penile cancer. J Nucl Med 46(9):1460–1465PubMed
18.
Zurück zum Zitat Schlenker B et al (2009) Detection of inguinal lymph node involvement in penile squamous cell carcinoma by 18F-fluorodeoxyglucose PET/CT: a prospective single-center study. Urol Oncol 30(9):753–769 Schlenker B et al (2009) Detection of inguinal lymph node involvement in penile squamous cell carcinoma by 18F-fluorodeoxyglucose PET/CT: a prospective single-center study. Urol Oncol 30(9):753–769
19.
Zurück zum Zitat Graafland NM et al (2010) 18F-FDG PET/CT for monitoring induction chemotherapy in patients with primary inoperable penile carcinoma: first clinical results. Eur J Nucl Med Mol Imaging 37(8):1474–1480PubMedCrossRef Graafland NM et al (2010) 18F-FDG PET/CT for monitoring induction chemotherapy in patients with primary inoperable penile carcinoma: first clinical results. Eur J Nucl Med Mol Imaging 37(8):1474–1480PubMedCrossRef
20.
21.
Zurück zum Zitat Tabatabaei S, Harisinghani M, McDougal WS (2005) Regional lymph node staging using lymphotropic nanoparticle enhanced magnetic resonance imaging with ferumoxtran-10 in patients with penile cancer. J Urol 174(3):923–927 discussion 927PubMedCrossRef Tabatabaei S, Harisinghani M, McDougal WS (2005) Regional lymph node staging using lymphotropic nanoparticle enhanced magnetic resonance imaging with ferumoxtran-10 in patients with penile cancer. J Urol 174(3):923–927 discussion 927PubMedCrossRef
22.
Zurück zum Zitat D’Ancona CA et al (1997) Quality of life after partial penectomy for penile carcinoma. Urology 50(4):593–596PubMedCrossRef D’Ancona CA et al (1997) Quality of life after partial penectomy for penile carcinoma. Urology 50(4):593–596PubMedCrossRef
23.
Zurück zum Zitat Horenblas S, van Tinteren H (1994) Squamous cell carcinoma of the penis. IV. Prognostic factors of survival: analysis of tumor, nodes and metastasis classification system. J Urol 151(5):1239–1243PubMed Horenblas S, van Tinteren H (1994) Squamous cell carcinoma of the penis. IV. Prognostic factors of survival: analysis of tumor, nodes and metastasis classification system. J Urol 151(5):1239–1243PubMed
24.
Zurück zum Zitat Davis JW, Schellhammer PF, Schlossberg SM (1999) Conservative surgical therapy for penile and urethral carcinoma. Urology 53(2):386–392PubMedCrossRef Davis JW, Schellhammer PF, Schlossberg SM (1999) Conservative surgical therapy for penile and urethral carcinoma. Urology 53(2):386–392PubMedCrossRef
25.
Zurück zum Zitat Solsona E et al (2001) Prospective validation of association of local tumor stage and grade as predictive factor for occult lymph node micrometastases in patients with penile carcinoma and clinically negative inguinal lymph nodes. J Urol 165(5):1506–1509PubMedCrossRef Solsona E et al (2001) Prospective validation of association of local tumor stage and grade as predictive factor for occult lymph node micrometastases in patients with penile carcinoma and clinically negative inguinal lymph nodes. J Urol 165(5):1506–1509PubMedCrossRef
26.
Zurück zum Zitat Hegarty PK et al (2006) A prospective study of 100 cases of penile cancer managed according to European association of urology guidelines. BJU Int 98(3):526–531PubMedCrossRef Hegarty PK et al (2006) A prospective study of 100 cases of penile cancer managed according to European association of urology guidelines. BJU Int 98(3):526–531PubMedCrossRef
27.
Zurück zum Zitat Thuret R et al (2010) A contemporary population-based assessment of the rate of lymph node dissection for penile carcinoma. Ann Surg Oncol 18(2):439–446PubMedCrossRef Thuret R et al (2010) A contemporary population-based assessment of the rate of lymph node dissection for penile carcinoma. Ann Surg Oncol 18(2):439–446PubMedCrossRef
28.
Zurück zum Zitat Cabanas RM (1992) Anatomy and biopsy of sentinel lymph nodes. Urol Clin North Am 19(2):267–276PubMed Cabanas RM (1992) Anatomy and biopsy of sentinel lymph nodes. Urol Clin North Am 19(2):267–276PubMed
29.
Zurück zum Zitat Pettaway CA et al (1995) Sentinel lymph-node dissection for penile carcinoma: the M-D-Anderson-cancer-center experience. J Urol 154(6):1999–2003PubMedCrossRef Pettaway CA et al (1995) Sentinel lymph-node dissection for penile carcinoma: the M-D-Anderson-cancer-center experience. J Urol 154(6):1999–2003PubMedCrossRef
30.
Zurück zum Zitat Tanis PJ et al (2002) Dynamic sentinel node biopsy for penile cancer: reliability of a staging technique. J Urol 168(1):76–80PubMedCrossRef Tanis PJ et al (2002) Dynamic sentinel node biopsy for penile cancer: reliability of a staging technique. J Urol 168(1):76–80PubMedCrossRef
31.
Zurück zum Zitat Spiess PE, Hernandez MS, Pettaway CA (2009) Contemporary inguinal lymph node dissection: minimizing complications. World J Urol 27(2):205–212PubMedCrossRef Spiess PE, Hernandez MS, Pettaway CA (2009) Contemporary inguinal lymph node dissection: minimizing complications. World J Urol 27(2):205–212PubMedCrossRef
32.
Zurück zum Zitat Hughes BE et al (2010) Lymph node metastasis in intermediate-risk penile squamous cell cancer: a two-centre experience. Eur Urol 57(4):688–692PubMedCrossRef Hughes BE et al (2010) Lymph node metastasis in intermediate-risk penile squamous cell cancer: a two-centre experience. Eur Urol 57(4):688–692PubMedCrossRef
33.
Zurück zum Zitat Sanchez-Ortiz RF, Pettaway CA (2004) The role of lymphadenectomy in penile cancer. Urol Oncol 22(3):236–244 discussion 244–245PubMedCrossRef Sanchez-Ortiz RF, Pettaway CA (2004) The role of lymphadenectomy in penile cancer. Urol Oncol 22(3):236–244 discussion 244–245PubMedCrossRef
34.
Zurück zum Zitat Daseler EH, Anson BJ, Reimann AF (1948) Radical excision of the inguinal and iliac lymph glands: a study based upon 450 anatomical dissections and upon supportive clinical observations. Surg Gynecol Obstet 87(6):679–694PubMed Daseler EH, Anson BJ, Reimann AF (1948) Radical excision of the inguinal and iliac lymph glands: a study based upon 450 anatomical dissections and upon supportive clinical observations. Surg Gynecol Obstet 87(6):679–694PubMed
35.
Zurück zum Zitat Evriviades D, Raurell A, Perks AG (2007) Pedicled anterolateral thigh flap for reconstruction after radical groin dissection. Urology 70(5):996–999PubMedCrossRef Evriviades D, Raurell A, Perks AG (2007) Pedicled anterolateral thigh flap for reconstruction after radical groin dissection. Urology 70(5):996–999PubMedCrossRef
36.
Zurück zum Zitat Bermejo C et al (2007) Neoadjuvant chemotherapy followed by aggressive surgical consolidation for metastatic penile squamous cell carcinoma. J Urol 177(4):1335–1338PubMedCrossRef Bermejo C et al (2007) Neoadjuvant chemotherapy followed by aggressive surgical consolidation for metastatic penile squamous cell carcinoma. J Urol 177(4):1335–1338PubMedCrossRef
37.
Zurück zum Zitat Assimos DG, Jarow JP (1994) Role of laparoscopic pelvic lymph node dissection in the management of patients with penile cancer and inguinal adenopathy. J Endourol 8(5):365–369PubMedCrossRef Assimos DG, Jarow JP (1994) Role of laparoscopic pelvic lymph node dissection in the management of patients with penile cancer and inguinal adenopathy. J Endourol 8(5):365–369PubMedCrossRef
38.
Zurück zum Zitat Mahlmann B, Doehn C, Feyerabend T (2001) Radiotherapy of penile cancer. Urol A 40(4):308CrossRef Mahlmann B, Doehn C, Feyerabend T (2001) Radiotherapy of penile cancer. Urol A 40(4):308CrossRef
39.
Zurück zum Zitat de Crevoisier R et al (2009) Long-term results of brachytherapy for carcinoma of the penis confined to the glans (N− or NX). Int J Radiat Oncol Biol Phys 74(4):1150–1156PubMedCrossRef de Crevoisier R et al (2009) Long-term results of brachytherapy for carcinoma of the penis confined to the glans (N− or NX). Int J Radiat Oncol Biol Phys 74(4):1150–1156PubMedCrossRef
40.
Zurück zum Zitat Crook J, Ma C, Grimard L (2009) Radiation therapy in the management of the primary penile tumor: an update. World J Urol 27(2):189–196PubMedCrossRef Crook J, Ma C, Grimard L (2009) Radiation therapy in the management of the primary penile tumor: an update. World J Urol 27(2):189–196PubMedCrossRef
41.
Zurück zum Zitat Crook J, Jezioranski J, Cygler JE (2010) Penile brachytherapy: technical aspects and post implant issues. Brachytherapy 9(2):151–158PubMedCrossRef Crook J, Jezioranski J, Cygler JE (2010) Penile brachytherapy: technical aspects and post implant issues. Brachytherapy 9(2):151–158PubMedCrossRef
42.
Zurück zum Zitat Crook JM et al (2005) Penile brachytherapy: results for 49 patients. Int J Radiat Oncol Biol Phys 62(2):460–467PubMedCrossRef Crook JM et al (2005) Penile brachytherapy: results for 49 patients. Int J Radiat Oncol Biol Phys 62(2):460–467PubMedCrossRef
43.
Zurück zum Zitat Murrell DS, Williams JL (1965) Radiotherapy in the treatment of carcinoma of the penis. Br J Urol 37:211–222PubMedCrossRef Murrell DS, Williams JL (1965) Radiotherapy in the treatment of carcinoma of the penis. Br J Urol 37:211–222PubMedCrossRef
44.
Zurück zum Zitat Edsmyr F, Andersson L, Esposti PL (1985) Combined bleomycin and radiation therapy in carcinoma of the penis. Cancer 56(6):1257–1263PubMedCrossRef Edsmyr F, Andersson L, Esposti PL (1985) Combined bleomycin and radiation therapy in carcinoma of the penis. Cancer 56(6):1257–1263PubMedCrossRef
45.
Zurück zum Zitat Ahmed T, Sklaroff R, Yagoda A (1984) An appraisal of the efficacy of bleomycin in epidermoid carcinoma of the penis. Anticancer Res 4(4–5):289–292PubMed Ahmed T, Sklaroff R, Yagoda A (1984) An appraisal of the efficacy of bleomycin in epidermoid carcinoma of the penis. Anticancer Res 4(4–5):289–292PubMed
46.
Zurück zum Zitat Ahmed T, Sklaroff R, Yagoda A (1984) Sequential trials of methotrexate, cisplatin and bleomycin for penile cancer. J Urol 132(3):465–468PubMed Ahmed T, Sklaroff R, Yagoda A (1984) Sequential trials of methotrexate, cisplatin and bleomycin for penile cancer. J Urol 132(3):465–468PubMed
47.
Zurück zum Zitat Hussein AM, Benedetto P, Sridhar KS (1990) Chemotherapy with cisplatin and 5-fluorouracil for penile and urethral squamous cell carcinomas. Cancer 65(3):433–438PubMedCrossRef Hussein AM, Benedetto P, Sridhar KS (1990) Chemotherapy with cisplatin and 5-fluorouracil for penile and urethral squamous cell carcinomas. Cancer 65(3):433–438PubMedCrossRef
48.
Zurück zum Zitat Dexeus FH et al (1991) Combination chemotherapy with methotrexate, bleomycin and cisplatin for advanced squamous cell carcinoma of the male genital tract. J Urol 146(5):1284–1287PubMed Dexeus FH et al (1991) Combination chemotherapy with methotrexate, bleomycin and cisplatin for advanced squamous cell carcinoma of the male genital tract. J Urol 146(5):1284–1287PubMed
49.
Zurück zum Zitat Hakenberg OW et al (2006) Cisplatin, methotrexate and bleomycin for treating advanced penile carcinoma. BJU Int 98(6):1225–1227PubMedCrossRef Hakenberg OW et al (2006) Cisplatin, methotrexate and bleomycin for treating advanced penile carcinoma. BJU Int 98(6):1225–1227PubMedCrossRef
50.
Zurück zum Zitat Pizzocaro G, Piva L (1998) Adjuvant and neoadjuvant vincristine, bleomycin, and methotrexate for inguinal metastases from squamous cell carcinoma of the penis. Acta Oncol 27(6b):823–824 Pizzocaro G, Piva L (1998) Adjuvant and neoadjuvant vincristine, bleomycin, and methotrexate for inguinal metastases from squamous cell carcinoma of the penis. Acta Oncol 27(6b):823–824
51.
Zurück zum Zitat Theodore C et al (2008) A phase II multicentre study of irinotecan (CPT 11) in combination with cisplatin (CDDP) in metastatic or locally advanced penile carcinoma (EORTC PROTOCOL 30992). Ann Oncol 19(7):1304–1307PubMedCrossRef Theodore C et al (2008) A phase II multicentre study of irinotecan (CPT 11) in combination with cisplatin (CDDP) in metastatic or locally advanced penile carcinoma (EORTC PROTOCOL 30992). Ann Oncol 19(7):1304–1307PubMedCrossRef
52.
Zurück zum Zitat Pagliaro LC et al (2010) Neoadjuvant paclitaxel, ifosfamide, and cisplatin chemotherapy for metastatic penile cancer: a phase II study. J Clin Oncol 28(24):3851–3857PubMedCrossRef Pagliaro LC et al (2010) Neoadjuvant paclitaxel, ifosfamide, and cisplatin chemotherapy for metastatic penile cancer: a phase II study. J Clin Oncol 28(24):3851–3857PubMedCrossRef
53.
Zurück zum Zitat Modig H, Duchek M, Sjodin JG (1993) Carcinoma of the penis. Treatment by surgery or combined bleomycin and radiation therapy. Acta Oncol 32(6):653–655PubMedCrossRef Modig H, Duchek M, Sjodin JG (1993) Carcinoma of the penis. Treatment by surgery or combined bleomycin and radiation therapy. Acta Oncol 32(6):653–655PubMedCrossRef
54.
Zurück zum Zitat Gotsadze D et al (2000) Is conservative organ-sparing treatment of penile carcinoma justified? Eur Urol 38(3):306–312PubMedCrossRef Gotsadze D et al (2000) Is conservative organ-sparing treatment of penile carcinoma justified? Eur Urol 38(3):306–312PubMedCrossRef
55.
Zurück zum Zitat Perez-Tamayot C (1987) Combined approach to squamous cell carcinoma of the penis (SCP). Proc Am Soc Clin Oncol 6:109 Perez-Tamayot C (1987) Combined approach to squamous cell carcinoma of the penis (SCP). Proc Am Soc Clin Oncol 6:109
56.
Zurück zum Zitat Clavel M et al (1994) Randomized comparison of cisplatin, methotrexate, bleomycin and vincristine (CABO) versus cisplatin and 5-fluorouracil (CF) versus cisplatin (C) in recurrent or metastatic squamous cell carcinoma of the head and neck. A phase III study of the EORTC head and neck cancer cooperative group. Ann Oncol 5(6):521–526PubMed Clavel M et al (1994) Randomized comparison of cisplatin, methotrexate, bleomycin and vincristine (CABO) versus cisplatin and 5-fluorouracil (CF) versus cisplatin (C) in recurrent or metastatic squamous cell carcinoma of the head and neck. A phase III study of the EORTC head and neck cancer cooperative group. Ann Oncol 5(6):521–526PubMed
57.
Zurück zum Zitat Leijte JA et al (2007) Neoadjuvant chemotherapy in advanced penile carcinoma. Eur Urol 52(2):488–494PubMedCrossRef Leijte JA et al (2007) Neoadjuvant chemotherapy in advanced penile carcinoma. Eur Urol 52(2):488–494PubMedCrossRef
58.
Zurück zum Zitat Edge SB, Byrd DR, Compton CC et al (eds) (2010) AJCC cancer staging manual, 7th edn. Springer, NY, p 449 Edge SB, Byrd DR, Compton CC et al (eds) (2010) AJCC cancer staging manual, 7th edn. Springer, NY, p 449
Metadaten
Titel
Advanced penile cancer
verfasst von
Jonathan E. Heinlen
David D. Buethe
Daniel Joseph Culkin
Publikationsdatum
01.02.2012
Verlag
Springer Netherlands
Erschienen in
International Urology and Nephrology / Ausgabe 1/2012
Print ISSN: 0301-1623
Elektronische ISSN: 1573-2584
DOI
https://doi.org/10.1007/s11255-011-0011-1

Weitere Artikel der Ausgabe 1/2012

International Urology and Nephrology 1/2012 Zur Ausgabe

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Bei seelischem Stress sind Checkpoint-Hemmer weniger wirksam

03.06.2024 NSCLC Nachrichten

Wie stark Menschen mit fortgeschrittenem NSCLC von einer Therapie mit Immun-Checkpoint-Hemmern profitieren, hängt offenbar auch davon ab, wie sehr die Diagnose ihre psychische Verfassung erschüttert

Antikörper mobilisiert Neutrophile gegen Krebs

03.06.2024 Onkologische Immuntherapie Nachrichten

Ein bispezifischer Antikörper formiert gezielt eine Armee neutrophiler Granulozyten gegen Krebszellen. An den Antikörper gekoppeltes TNF-alpha soll die Zellen zudem tief in solide Tumoren hineinführen.

Erhebliches Risiko für Kehlkopfkrebs bei mäßiger Dysplasie

29.05.2024 Larynxkarzinom Nachrichten

Fast ein Viertel der Personen mit mäßig dysplastischen Stimmlippenläsionen entwickelt einen Kehlkopftumor. Solche Personen benötigen daher eine besonders enge ärztliche Überwachung.

Nach Herzinfarkt mit Typ-1-Diabetes schlechtere Karten als mit Typ 2?

29.05.2024 Herzinfarkt Nachrichten

Bei Menschen mit Typ-2-Diabetes sind die Chancen, einen Myokardinfarkt zu überleben, in den letzten 15 Jahren deutlich gestiegen – nicht jedoch bei Betroffenen mit Typ 1.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.