Skip to main content
Erschienen in: Annals of Surgical Oncology 7/2011

01.07.2011 | Thoracic Oncology

HER-2/neu Gene Amplification in Esophageal Adenocarcinoma and Its Influence on Survival

verfasst von: Sarah K. Thompson, MD, FRCSC, Thomas R. Sullivan, BMa&CompSc(Hons), Ruth Davies, BMedSc, Andrew R. Ruszkiewicz, MD, FRCPA

Erschienen in: Annals of Surgical Oncology | Ausgabe 7/2011

Einloggen, um Zugang zu erhalten

Abstract

Background

HER-2/neu (c-erbB-2, HER2) gene amplification and protein overexpression have been associated with poor prognosis in several solid tumors, including breast and gastric cancer. Its incidence and significance in esophageal adenocarcinoma is unknown.

Materials and Methods

Tissue microarrays were successfully constructed from 89 paraffin-embedded archival specimens of esophageal adenocarcinomas for HER2 gene amplification by silver-enhanced in situ hybridization (SISH). No patients had undergone neoadjuvant therapy. Protein overexpression was tested with immunohistochemistry (IHC) using automated immunostaining (Ventana Benchmark). Incidence of HER2 positivity, correlation to clinicopathological variables in esophageal cancer patients, and concordance between SISH and IHC were determined.

Results

True HER2 gene amplification was detected in 14 esophageal cancer specimens (16%), and 92% of those with high-level HER2 amplification showed positive HER2 protein overexpression. No significant associations were found among gene amplification and clinicopathological factors. The 5-year survival rates were 57% for esophageal cancer patients with HER2 amplification compared with 32% without, but the difference in overall survival was not significant (P = .37). The correlation between SISH and IHC was statistically significant (P < .0001).

Conclusion

While molecular targeting may be possible for approximately 16% of esophageal adenocarcinoma patients, HER2 oncogene amplification did not influence survival in this study.
Literatur
1.
Zurück zum Zitat Thompson SK, Ruszkiewicz AR, Jamieson GG, Esterman A, Watson DI, Wijnhoven BP, et al. Improving the accuracy of TNM staging in esophageal cancer: a pathological review of resected specimens. Ann Surg Oncol. 2008;15:3447–58.PubMedCrossRef Thompson SK, Ruszkiewicz AR, Jamieson GG, Esterman A, Watson DI, Wijnhoven BP, et al. Improving the accuracy of TNM staging in esophageal cancer: a pathological review of resected specimens. Ann Surg Oncol. 2008;15:3447–58.PubMedCrossRef
2.
Zurück zum Zitat Penault-Llorca F, Bilous M, Dowsett M, Hanna W, Osamura RY, Rüschoff J, et al. Emerging technologies for assessing HER2 amplification. Am J Clin Pathol. 2009;132:539–48.PubMedCrossRef Penault-Llorca F, Bilous M, Dowsett M, Hanna W, Osamura RY, Rüschoff J, et al. Emerging technologies for assessing HER2 amplification. Am J Clin Pathol. 2009;132:539–48.PubMedCrossRef
3.
Zurück zum Zitat Walker RA, Bartlett JM, Dowsett M, Ellis IO, Hanby AM, Jasani B, et al. HER2 testing in the UK: further update to recommendations. J Clin Pathol. 2008;61:818–24.PubMedCrossRef Walker RA, Bartlett JM, Dowsett M, Ellis IO, Hanby AM, Jasani B, et al. HER2 testing in the UK: further update to recommendations. J Clin Pathol. 2008;61:818–24.PubMedCrossRef
4.
Zurück zum Zitat Boone J, van Hillegersberg R, Offerhaus GJA, van Diest PJ, Borel Rinkes IHM, ten Kate FJW. Targets for molecular therapy in esophageal squamous cell carcinoma: an immunohistochemical analysis. Dis Esophagus. 2009;22:496–504.PubMedCrossRef Boone J, van Hillegersberg R, Offerhaus GJA, van Diest PJ, Borel Rinkes IHM, ten Kate FJW. Targets for molecular therapy in esophageal squamous cell carcinoma: an immunohistochemical analysis. Dis Esophagus. 2009;22:496–504.PubMedCrossRef
5.
Zurück zum Zitat Sato-Kuwabara Y, Neves JI, Fregnani JH, Sallum RA, Soares FA. Evaluation of gene amplification and protein expression of HER-2/neu in esophageal squamous cell carcinoma using Fluorescence in situ Hybridization (FISH) and immunohistochemistry. BMC Cancer. 2009;9:6.PubMedCrossRef Sato-Kuwabara Y, Neves JI, Fregnani JH, Sallum RA, Soares FA. Evaluation of gene amplification and protein expression of HER-2/neu in esophageal squamous cell carcinoma using Fluorescence in situ Hybridization (FISH) and immunohistochemistry. BMC Cancer. 2009;9:6.PubMedCrossRef
6.
Zurück zum Zitat Arrington AK, Dahlberg PS, Davydova J, Vickers SM, Yamamoto M. ERBB2 suppression decreases cell growth via apoptosis in gastrointestinal adenocarcinomas. Surgery. 2009;146:213–9.PubMedCrossRef Arrington AK, Dahlberg PS, Davydova J, Vickers SM, Yamamoto M. ERBB2 suppression decreases cell growth via apoptosis in gastrointestinal adenocarcinomas. Surgery. 2009;146:213–9.PubMedCrossRef
7.
Zurück zum Zitat Dahlberg PS, Jacobson BA, Dahal G, Fink JM, Kratzke RA, Maddaus MA, et al. ERBB2 amplifications in esophageal adenocarcinoma. Ann Thorac Surg. 2004;78:1790–800.PubMedCrossRef Dahlberg PS, Jacobson BA, Dahal G, Fink JM, Kratzke RA, Maddaus MA, et al. ERBB2 amplifications in esophageal adenocarcinoma. Ann Thorac Surg. 2004;78:1790–800.PubMedCrossRef
8.
Zurück zum Zitat Bekaii-Saab TS, Roda JM, Guenterberg KD, Ramaswamy B, Young DC, Ferketich AK, et al. A phase I trial of paclitaxel and trastuzumab in combination with interleukin-12 in patients with HER2/neu-expressing malignancies. Mol Cancer Ther. 2009;8:2983–91.PubMedCrossRef Bekaii-Saab TS, Roda JM, Guenterberg KD, Ramaswamy B, Young DC, Ferketich AK, et al. A phase I trial of paclitaxel and trastuzumab in combination with interleukin-12 in patients with HER2/neu-expressing malignancies. Mol Cancer Ther. 2009;8:2983–91.PubMedCrossRef
9.
Zurück zum Zitat Lesnikova I, Lidang M, Hamilton-Dutoit S, Koch J. HER2/neu (c-erbB-2) gene amplification and protein expression are rare in uterine cervical neoplasia: a tissue microarray study of 814 archival specimens. APMIS. 2009;117:737–45.PubMedCrossRef Lesnikova I, Lidang M, Hamilton-Dutoit S, Koch J. HER2/neu (c-erbB-2) gene amplification and protein expression are rare in uterine cervical neoplasia: a tissue microarray study of 814 archival specimens. APMIS. 2009;117:737–45.PubMedCrossRef
10.
Zurück zum Zitat Brien TP, Odze RD, Sheehan CE, McKenna BJ, Ross JS. HER-2/neu gene amplification by FISH predicts poor survival in Barrett’s esophagus-associated adenocarcinoma. Hum Pathol. 2000;31:35–9.PubMedCrossRef Brien TP, Odze RD, Sheehan CE, McKenna BJ, Ross JS. HER-2/neu gene amplification by FISH predicts poor survival in Barrett’s esophagus-associated adenocarcinoma. Hum Pathol. 2000;31:35–9.PubMedCrossRef
11.
Zurück zum Zitat Bang YJ, Cutsem EV, Feyereislova A, Chung HC, Shen L, Sawaki A, et al. Trastuzumab in combination with chemotherapy versus chemotherapy alone for treatment of HER2-positive advanced gastric or gastro-oesophageal junction cancer (ToGA): a phase 3, open-label, randomised controlled trial. Lancet. 2010;376:687–97.PubMedCrossRef Bang YJ, Cutsem EV, Feyereislova A, Chung HC, Shen L, Sawaki A, et al. Trastuzumab in combination with chemotherapy versus chemotherapy alone for treatment of HER2-positive advanced gastric or gastro-oesophageal junction cancer (ToGA): a phase 3, open-label, randomised controlled trial. Lancet. 2010;376:687–97.PubMedCrossRef
12.
Zurück zum Zitat Aly A, Jamieson GG, Pyragius M, Devitt PG. Antireflux anastamosis following oesophagectomy. ANZ J Surg. 2004;74:434–8.PubMedCrossRef Aly A, Jamieson GG, Pyragius M, Devitt PG. Antireflux anastamosis following oesophagectomy. ANZ J Surg. 2004;74:434–8.PubMedCrossRef
13.
Zurück zum Zitat Jamieson GG, Lamb PJ, Thompson SK. The role of lymphadenectomy in esophageal cancer. Ann Surg. 2009;250:206–9.PubMedCrossRef Jamieson GG, Lamb PJ, Thompson SK. The role of lymphadenectomy in esophageal cancer. Ann Surg. 2009;250:206–9.PubMedCrossRef
14.
Zurück zum Zitat Graham AD, Faratian D, Rae F, Thomas JS. Tissue microarray technology in the routine assessment of HER-2 status in invasive breast cancer: a prospective study of the use of immunohistochemistry and fluorescence in situ hybridization. Histopathology. 2008;52:847–55.PubMedCrossRef Graham AD, Faratian D, Rae F, Thomas JS. Tissue microarray technology in the routine assessment of HER-2 status in invasive breast cancer: a prospective study of the use of immunohistochemistry and fluorescence in situ hybridization. Histopathology. 2008;52:847–55.PubMedCrossRef
15.
Zurück zum Zitat Nitta H, Hauss-Wegrzniak B, Lehrkamp M, Murillo AE, Gaire F, Farrell M, et al. Development of automated brightfield double in situ hybridization (BDISH) application for HER2 gene and chromosome 17 centromere (CEN 17) for breast carcinomas and an assay performance comparison to manual dual color HER2 fluorescence in situ hybridization (FISH). Diagn Pathol. 2008;3:41.PubMedCrossRef Nitta H, Hauss-Wegrzniak B, Lehrkamp M, Murillo AE, Gaire F, Farrell M, et al. Development of automated brightfield double in situ hybridization (BDISH) application for HER2 gene and chromosome 17 centromere (CEN 17) for breast carcinomas and an assay performance comparison to manual dual color HER2 fluorescence in situ hybridization (FISH). Diagn Pathol. 2008;3:41.PubMedCrossRef
16.
Zurück zum Zitat Scheuemann P, Hosch SB, Izbicki JR. Cytokeratins and other sensitive markers for esophageal cancer and metastases. Dis Esophagus. 2001;14:85–90.PubMedCrossRef Scheuemann P, Hosch SB, Izbicki JR. Cytokeratins and other sensitive markers for esophageal cancer and metastases. Dis Esophagus. 2001;14:85–90.PubMedCrossRef
17.
Zurück zum Zitat Hofmann M, Stoss O, Shi D, Büttner R, van de Vijver M, Kim W, et al. Assessment of a HER2 scoring system for gastric cancer: results from a validation study. Histopathology. 2008;52:797–805.PubMedCrossRef Hofmann M, Stoss O, Shi D, Büttner R, van de Vijver M, Kim W, et al. Assessment of a HER2 scoring system for gastric cancer: results from a validation study. Histopathology. 2008;52:797–805.PubMedCrossRef
18.
Zurück zum Zitat Knight WE. A computer method for calculating Kendall’s Tau with ungrouped data. J Am Stat Assoc. 1966;61:436–9.CrossRef Knight WE. A computer method for calculating Kendall’s Tau with ungrouped data. J Am Stat Assoc. 1966;61:436–9.CrossRef
19.
Zurück zum Zitat Fléjou JF, Paraf F, Muzeau F, Fékété F, Hénin D, Jothy S, et al. Expression of c-erbB-2 oncogene product in Barrett’s adenocarcinoma: pathological and prognostic correlations. J Clin Pathol. 1994;47:23–6.PubMedCrossRef Fléjou JF, Paraf F, Muzeau F, Fékété F, Hénin D, Jothy S, et al. Expression of c-erbB-2 oncogene product in Barrett’s adenocarcinoma: pathological and prognostic correlations. J Clin Pathol. 1994;47:23–6.PubMedCrossRef
20.
Zurück zum Zitat Nakamura T, Nekarda H, Hoelscher AH, Bollschweiler E, Harbec N, Becker K, et al. Prognostic value of DNA ploidy and c-erbB-2 oncoprotein overexpression in adenocarcinoma of Barrett’s esophagus. Cancer. 1994;73:1785–94.PubMedCrossRef Nakamura T, Nekarda H, Hoelscher AH, Bollschweiler E, Harbec N, Becker K, et al. Prognostic value of DNA ploidy and c-erbB-2 oncoprotein overexpression in adenocarcinoma of Barrett’s esophagus. Cancer. 1994;73:1785–94.PubMedCrossRef
21.
Zurück zum Zitat Jankowski J, Coghill G, Hopwood D, Wormsley KG. Oncogenes and onco-suppressor gene in adenocarcinoma of the oesophagus. Gut. 1992;33:1033–8.PubMedCrossRef Jankowski J, Coghill G, Hopwood D, Wormsley KG. Oncogenes and onco-suppressor gene in adenocarcinoma of the oesophagus. Gut. 1992;33:1033–8.PubMedCrossRef
22.
Zurück zum Zitat Friess H, Fukuda A, Tang WH, Eichenberger A, Furlan N, Zimmermann A, et al. Concomitant analysis of the epidermal growth factor receptor family in esophageal cancer: overexpression of epidermal growth factor receptor mRNA but not of c-erbB-2 and c-erbB-3. World J Surg. 1999;23:1010–8.PubMedCrossRef Friess H, Fukuda A, Tang WH, Eichenberger A, Furlan N, Zimmermann A, et al. Concomitant analysis of the epidermal growth factor receptor family in esophageal cancer: overexpression of epidermal growth factor receptor mRNA but not of c-erbB-2 and c-erbB-3. World J Surg. 1999;23:1010–8.PubMedCrossRef
23.
Zurück zum Zitat Hardwick RH, Barham CP, Ozua P, Newcomb PV, Savage P, Powell R, et al. Immunohistochemical detection of p53 and c-erbB-2 in oesophageal carcinoma; no correlation with prognosis. Eur J Surg Oncol. 1997;23:30–5.PubMedCrossRef Hardwick RH, Barham CP, Ozua P, Newcomb PV, Savage P, Powell R, et al. Immunohistochemical detection of p53 and c-erbB-2 in oesophageal carcinoma; no correlation with prognosis. Eur J Surg Oncol. 1997;23:30–5.PubMedCrossRef
24.
Zurück zum Zitat Al-Kasspooles M, Moore JH, Orringer MB, Beer DG. Amplification and over-expression of the EGFR and erbB-2 genes in human esophageal adenocarcinomas. Int J Cancer. 1993;54:213–9.PubMedCrossRef Al-Kasspooles M, Moore JH, Orringer MB, Beer DG. Amplification and over-expression of the EGFR and erbB-2 genes in human esophageal adenocarcinomas. Int J Cancer. 1993;54:213–9.PubMedCrossRef
25.
Zurück zum Zitat Duhaylongsod FG, Gottfried MR, Iglehart JD, Vaughn AL, Wolfe WG. The significance of c-erbB-2 and p53 immunoreactivity in patients with adenocarcinoma of the esophagus. Ann Surg. 1995;221:677–84.PubMedCrossRef Duhaylongsod FG, Gottfried MR, Iglehart JD, Vaughn AL, Wolfe WG. The significance of c-erbB-2 and p53 immunoreactivity in patients with adenocarcinoma of the esophagus. Ann Surg. 1995;221:677–84.PubMedCrossRef
26.
Zurück zum Zitat Walch A, Specht K, Bink K, Zitzelsberger H, Braselmann H, Bauer M, et al. Her-2/neu gene amplification, elevated mRNA expression, and protein overexpression in the metaplasia-dysplasia-adenocarcinoma sequence of Barrett’s esophagus. Lab Invest. 2001;81:791–801.PubMed Walch A, Specht K, Bink K, Zitzelsberger H, Braselmann H, Bauer M, et al. Her-2/neu gene amplification, elevated mRNA expression, and protein overexpression in the metaplasia-dysplasia-adenocarcinoma sequence of Barrett’s esophagus. Lab Invest. 2001;81:791–801.PubMed
27.
Zurück zum Zitat Reichelt U, Duesedau P, Tsourlakis MCh, Quaas A, Link BC, Schurr PG, et al. Frequent homogeneous HER-2 amplification in primary and metastatic adenocarcinoma of the esophagus. Mod Pathol. 2007;20:120–9.PubMedCrossRef Reichelt U, Duesedau P, Tsourlakis MCh, Quaas A, Link BC, Schurr PG, et al. Frequent homogeneous HER-2 amplification in primary and metastatic adenocarcinoma of the esophagus. Mod Pathol. 2007;20:120–9.PubMedCrossRef
28.
Zurück zum Zitat Geddert H, Zeriouh M, Wolter M, Heise JW, Gabbert HE, Sarbia M. Gene amplification and protein overexpression of c-erb-b2 in Barrett carcinoma and its precursor lesions. Am J Clin Pathol. 2002;118:60–6.PubMedCrossRef Geddert H, Zeriouh M, Wolter M, Heise JW, Gabbert HE, Sarbia M. Gene amplification and protein overexpression of c-erb-b2 in Barrett carcinoma and its precursor lesions. Am J Clin Pathol. 2002;118:60–6.PubMedCrossRef
29.
Zurück zum Zitat Tanner M, Hollmén M, Junttila TT, Kapanen AI, Tommola S, Soini Y, et al. Amplification of HER-2 in gastric carcinoma: association with Topoisomerase IIα gene amplification, intestinal type, poor prognosis and sensitivity to trastuzumab. Ann Oncol. 2005;16:273–8.PubMedCrossRef Tanner M, Hollmén M, Junttila TT, Kapanen AI, Tommola S, Soini Y, et al. Amplification of HER-2 in gastric carcinoma: association with Topoisomerase IIα gene amplification, intestinal type, poor prognosis and sensitivity to trastuzumab. Ann Oncol. 2005;16:273–8.PubMedCrossRef
30.
Zurück zum Zitat Rosenberg CL. Polysomy 17 and HER-2 amplification: true, true, and unrelated. J Clin Oncol. 2008;26:4856–8.PubMedCrossRef Rosenberg CL. Polysomy 17 and HER-2 amplification: true, true, and unrelated. J Clin Oncol. 2008;26:4856–8.PubMedCrossRef
31.
Zurück zum Zitat Yan B, Yau EX, Bte Omar SS, Ong CW, Pang B, Yeoh KG, et al. A study of HER2 gene amplification and protein expression in gastric cancer. J Clin Pathol. 2010;63:839–42.PubMedCrossRef Yan B, Yau EX, Bte Omar SS, Ong CW, Pang B, Yeoh KG, et al. A study of HER2 gene amplification and protein expression in gastric cancer. J Clin Pathol. 2010;63:839–42.PubMedCrossRef
32.
Zurück zum Zitat Gravalos C, Jimeno A. HER2 in gastric cancer: a new prognostic factor and a novel therapeutic target. Ann Oncol. 2008;19:1523–9.PubMedCrossRef Gravalos C, Jimeno A. HER2 in gastric cancer: a new prognostic factor and a novel therapeutic target. Ann Oncol. 2008;19:1523–9.PubMedCrossRef
33.
Zurück zum Zitat Grabsch H, Sivakumar S, Gray S, Gabbert HE, Müller W. HER2 expression in gastric cancer: rare, heterogeneous and of no prognostic value – conclusions from 924 cases of two independent series. Cell Oncol. 2010;32:57–65.PubMed Grabsch H, Sivakumar S, Gray S, Gabbert HE, Müller W. HER2 expression in gastric cancer: rare, heterogeneous and of no prognostic value – conclusions from 924 cases of two independent series. Cell Oncol. 2010;32:57–65.PubMed
34.
Zurück zum Zitat Gibault L, Metges JP, Conan-Charlet V, Lozac’h P, Robaszkiewicz M, Bessaguet C, et. al. Diffuse EGFR staining is associated with reduced overall survival in locally advanced oesophageal squamous cell cancer. Br J Cancer. 2005;93:107–15.PubMedCrossRef Gibault L, Metges JP, Conan-Charlet V, Lozac’h P, Robaszkiewicz M, Bessaguet C, et. al. Diffuse EGFR staining is associated with reduced overall survival in locally advanced oesophageal squamous cell cancer. Br J Cancer. 2005;93:107–15.PubMedCrossRef
35.
Zurück zum Zitat Klein CA, Stoecklein NH. Lessons from an aggressive cancer: evolutionary dynamics in esophageal carcinoma. Cancer Res. 2009;69:5285–8.PubMedCrossRef Klein CA, Stoecklein NH. Lessons from an aggressive cancer: evolutionary dynamics in esophageal carcinoma. Cancer Res. 2009;69:5285–8.PubMedCrossRef
36.
Zurück zum Zitat Francis GD, Jones MA, Beadle GF, Stein SR. Bright-field in situ hybridization for HER2 gene amplification in breast cancer using tissue microarrays: correlation between chromogenic (CISH) and automated silver-enhanced (SISH) methods with patient outcome. Diagn Mol Pathol. 2009;18:88–95.PubMedCrossRef Francis GD, Jones MA, Beadle GF, Stein SR. Bright-field in situ hybridization for HER2 gene amplification in breast cancer using tissue microarrays: correlation between chromogenic (CISH) and automated silver-enhanced (SISH) methods with patient outcome. Diagn Mol Pathol. 2009;18:88–95.PubMedCrossRef
37.
Zurück zum Zitat Rauser S, Weis R, Braselman H, Feith M, Stein HJ, Langer R, et. al. Significance of HER2 low-level copy gain in Barrett’s cancer: implications for fluorescence in situ hybridization testing in tissues. Clin Cancer Res. 2007;13:5115–23.PubMedCrossRef Rauser S, Weis R, Braselman H, Feith M, Stein HJ, Langer R, et. al. Significance of HER2 low-level copy gain in Barrett’s cancer: implications for fluorescence in situ hybridization testing in tissues. Clin Cancer Res. 2007;13:5115–23.PubMedCrossRef
Metadaten
Titel
HER-2/neu Gene Amplification in Esophageal Adenocarcinoma and Its Influence on Survival
verfasst von
Sarah K. Thompson, MD, FRCSC
Thomas R. Sullivan, BMa&CompSc(Hons)
Ruth Davies, BMedSc
Andrew R. Ruszkiewicz, MD, FRCPA
Publikationsdatum
01.07.2011
Verlag
Springer-Verlag
Erschienen in
Annals of Surgical Oncology / Ausgabe 7/2011
Print ISSN: 1068-9265
Elektronische ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-011-1554-1

Weitere Artikel der Ausgabe 7/2011

Annals of Surgical Oncology 7/2011 Zur Ausgabe

Deutlich weniger Infektionen: Wundprotektoren schützen!

08.05.2024 Postoperative Wundinfektion Nachrichten

Der Einsatz von Wundprotektoren bei offenen Eingriffen am unteren Gastrointestinaltrakt schützt vor Infektionen im Op.-Gebiet – und dient darüber hinaus der besseren Sicht. Das bestätigt mit großer Robustheit eine randomisierte Studie im Fachblatt JAMA Surgery.

Chirurginnen und Chirurgen sind stark suizidgefährdet

07.05.2024 Suizid Nachrichten

Der belastende Arbeitsalltag wirkt sich negativ auf die psychische Gesundheit der Angehörigen ärztlicher Berufsgruppen aus. Chirurginnen und Chirurgen bilden da keine Ausnahme, im Gegenteil.

Ein Drittel der jungen Ärztinnen und Ärzte erwägt abzuwandern

07.05.2024 Medizinstudium Nachrichten

Extreme Arbeitsverdichtung und kaum Supervision: Dr. Andrea Martini, Sprecherin des Bündnisses Junge Ärztinnen und Ärzte (BJÄ) über den Frust des ärztlichen Nachwuchses und die Vorteile des Rucksack-Modells.

Echinokokkose medikamentös behandeln oder operieren?

06.05.2024 DCK 2024 Kongressbericht

Die Therapie von Echinokokkosen sollte immer in spezialisierten Zentren erfolgen. Eine symptomlose Echinokokkose kann – egal ob von Hunde- oder Fuchsbandwurm ausgelöst – konservativ erfolgen. Wenn eine Op. nötig ist, kann es sinnvoll sein, vorher Zysten zu leeren und zu desinfizieren. 

Update Chirurgie

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

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

Karpaltunnelsyndrom BDC Leitlinien Webinare
CME: 2 Punkte

Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

Radiusfraktur BDC Leitlinien Webinare
CME: 2 Punkte

Das Webinar beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Appendizitis BDC Leitlinien Webinare
CME: 2 Punkte

Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.