Skip to main content
Erschienen in: General Thoracic and Cardiovascular Surgery 7/2020

02.11.2019 | Special Edition

New T1 classification

verfasst von: Peter M. F. Lin, Michael K. Hsin

Erschienen in: General Thoracic and Cardiovascular Surgery | Ausgabe 7/2020

Einloggen, um Zugang zu erhalten

Abstract

The IASLC staging and Prognostic Factor Committee proposed new changes to the descriptors for the 8th edition of the Tumour Node Metastasis Staging for Lung Cancer. The T1 descriptor changes include (1) T1 tumours are subclassified into T1a (< 1 cm), T1b (> 1 to < 2 cm), T1c (> 2 to < 3 cm). The corresponding changes are introduced to the overall staging: T1aN0M0 = Stage IA1; T1bN0M0 = Stage IA2; T1cN0M0 = Stage IA3. (2) The introduction of the pathological entities Adenocarcinoma-In-Situ (AIS), Minimally Invasive Adenocarcinoma, and Lepidic Predominant Adenocarcinoma. The corresponding changes on the T descriptor are as follows: Adenocarcinoma-in situ is coded as Tis (AIS); Minimally Invasive Adenocarcinoma is coded as T1a(mi). In this review, the basis for these changes will be described, and the implications on clinical practice will be discussed.
Literatur
1.
Zurück zum Zitat Rami-Porta R, Goldstraw P. Strength and weakness of the new TNM classification for lung cancer. Eur Respir J. 2010;36(2):237–9.PubMedCrossRef Rami-Porta R, Goldstraw P. Strength and weakness of the new TNM classification for lung cancer. Eur Respir J. 2010;36(2):237–9.PubMedCrossRef
2.
Zurück zum Zitat Rami-Porta R, Bolejack V, Crowley J, Ball D, Kim J, Lyons G, et al. The IASLC Lung Cancer Staging Project: proposals for the revisions of the T descriptors in the forthcoming eighth edition of the TNM classification for lung cancer. J Thorac Oncol. 2015;10(7):990–1003.PubMedCrossRef Rami-Porta R, Bolejack V, Crowley J, Ball D, Kim J, Lyons G, et al. The IASLC Lung Cancer Staging Project: proposals for the revisions of the T descriptors in the forthcoming eighth edition of the TNM classification for lung cancer. J Thorac Oncol. 2015;10(7):990–1003.PubMedCrossRef
3.
Zurück zum Zitat Eberhardt WE, Mitchell A, Crowley J, Kondo H, Kim YT, Turrisi A 3rd, et al. The IASLC Lung Cancer Staging Project: proposals for the revision of the M descriptors in the forthcoming eighth edition of the TNM classification of lung cancer. J Thorac Oncol. 2015;10(11):1515–22.PubMedCrossRef Eberhardt WE, Mitchell A, Crowley J, Kondo H, Kim YT, Turrisi A 3rd, et al. The IASLC Lung Cancer Staging Project: proposals for the revision of the M descriptors in the forthcoming eighth edition of the TNM classification of lung cancer. J Thorac Oncol. 2015;10(11):1515–22.PubMedCrossRef
4.
Zurück zum Zitat Goldstraw P, Chansky K, Crowley J, Rami-Porta R, Asamura H, Eberhardt WE, et al. The IASLC Lung Cancer Staging Project: proposals for revision of the TNM stage groupings in the forthcoming (Eighth) edition of the TNM classification for lung cancer. J Thorac Oncol. 2016;11(1):39–51.PubMedCrossRef Goldstraw P, Chansky K, Crowley J, Rami-Porta R, Asamura H, Eberhardt WE, et al. The IASLC Lung Cancer Staging Project: proposals for revision of the TNM stage groupings in the forthcoming (Eighth) edition of the TNM classification for lung cancer. J Thorac Oncol. 2016;11(1):39–51.PubMedCrossRef
5.
Zurück zum Zitat Travis WD, Brambilla E, Noguchi M, Nicholson AG, Geisinger KR, Yatabe Y, et al. International association for the study of lung cancer/american thoracic society/european respiratory society international multidisciplinary classification of lung adenocarcinoma. J Thorac Oncol. 2011;6(2):244–85.PubMedPubMedCentralCrossRef Travis WD, Brambilla E, Noguchi M, Nicholson AG, Geisinger KR, Yatabe Y, et al. International association for the study of lung cancer/american thoracic society/european respiratory society international multidisciplinary classification of lung adenocarcinoma. J Thorac Oncol. 2011;6(2):244–85.PubMedPubMedCentralCrossRef
6.
Zurück zum Zitat Travis WDBE, Burke AP, Marx A, Nicholson AG. WHO classification of tumours of the lung, pleura, thymus and heart. 4th ed. Lyon: IARC publications; 2015. Travis WDBE, Burke AP, Marx A, Nicholson AG. WHO classification of tumours of the lung, pleura, thymus and heart. 4th ed. Lyon: IARC publications; 2015.
7.
Zurück zum Zitat Yoshizawa A, Motoi N, Riely GJ, Sima CS, Gerald WL, Kris MG, et al. Impact of proposed IASLC/ATS/ERS classification of lung adenocarcinoma: prognostic subgroups and implications for further revision of staging based on analysis of 514 stage I cases. Mod Pathol. 2011;24(5):653–64.PubMedCrossRef Yoshizawa A, Motoi N, Riely GJ, Sima CS, Gerald WL, Kris MG, et al. Impact of proposed IASLC/ATS/ERS classification of lung adenocarcinoma: prognostic subgroups and implications for further revision of staging based on analysis of 514 stage I cases. Mod Pathol. 2011;24(5):653–64.PubMedCrossRef
8.
Zurück zum Zitat Ito M, Miyata Y, Kushitani K, Yoshiya T, Mimae T, Ibuki Y, et al. Prediction for prognosis of resected pT1a-1bN0M0 adenocarcinoma based on tumor size and histological status: relationship of TNM and IASLC/ATS/ERS classifications. Lung Cancer (Amsterdam, Netherlands). 2014;85(2):270–5.CrossRef Ito M, Miyata Y, Kushitani K, Yoshiya T, Mimae T, Ibuki Y, et al. Prediction for prognosis of resected pT1a-1bN0M0 adenocarcinoma based on tumor size and histological status: relationship of TNM and IASLC/ATS/ERS classifications. Lung Cancer (Amsterdam, Netherlands). 2014;85(2):270–5.CrossRef
9.
Zurück zum Zitat Travis WD, Asamura H, Bankier AA, Beasley MB, Detterbeck F, Flieder DB, et al. The IASLC Lung Cancer Staging Project: proposals for coding T categories for subsolid nodules and assessment of tumor size in part-solid tumors in the forthcoming eighth edition of the TNM classification of lung cancer. J Thorac Oncol. 2016;11(8):1204–23.PubMedCrossRef Travis WD, Asamura H, Bankier AA, Beasley MB, Detterbeck F, Flieder DB, et al. The IASLC Lung Cancer Staging Project: proposals for coding T categories for subsolid nodules and assessment of tumor size in part-solid tumors in the forthcoming eighth edition of the TNM classification of lung cancer. J Thorac Oncol. 2016;11(8):1204–23.PubMedCrossRef
10.
Zurück zum Zitat Petrou M, Quint LE, Nan B, Baker LH. Pulmonary nodule volumetric measurement variability as a function of CT slice thickness and nodule morphology. AJR Am J Roentgenol. 2007;188(2):306–12.PubMedCrossRef Petrou M, Quint LE, Nan B, Baker LH. Pulmonary nodule volumetric measurement variability as a function of CT slice thickness and nodule morphology. AJR Am J Roentgenol. 2007;188(2):306–12.PubMedCrossRef
11.
Zurück zum Zitat Burt BM, Leung AN, Yanagawa M, Chen W, Groth SS, Hoang CD, et al. Diameter of solid tumor component alone should be used to establish T stage in lung adenocarcinoma. Ann Surg Oncol. 2015;22(Suppl 3):S1318–23.PubMedCrossRef Burt BM, Leung AN, Yanagawa M, Chen W, Groth SS, Hoang CD, et al. Diameter of solid tumor component alone should be used to establish T stage in lung adenocarcinoma. Ann Surg Oncol. 2015;22(Suppl 3):S1318–23.PubMedCrossRef
12.
Zurück zum Zitat Hwang EJ, Park CM, Ryu Y, Lee SM, Kim YT, Kim YW, et al. Pulmonary adenocarcinomas appearing as part-solid ground-glass nodules: is measuring solid component size a better prognostic indicator? Eur Radiol. 2015;25(2):558–67.PubMedCrossRef Hwang EJ, Park CM, Ryu Y, Lee SM, Kim YT, Kim YW, et al. Pulmonary adenocarcinomas appearing as part-solid ground-glass nodules: is measuring solid component size a better prognostic indicator? Eur Radiol. 2015;25(2):558–67.PubMedCrossRef
13.
Zurück zum Zitat Maeyashiki T, Suzuki K, Hattori A, Matsunaga T, Takamochi K, Oh S. The size of consolidation on thin-section computed tomography is a better predictor of survival than the maximum tumour dimension in resectable lung cancer. Eur J Cardio-thorac Surg. 2013;43(5):915–8.CrossRef Maeyashiki T, Suzuki K, Hattori A, Matsunaga T, Takamochi K, Oh S. The size of consolidation on thin-section computed tomography is a better predictor of survival than the maximum tumour dimension in resectable lung cancer. Eur J Cardio-thorac Surg. 2013;43(5):915–8.CrossRef
14.
Zurück zum Zitat Tsutani Y, Miyata Y, Nakayama H, Okumura S, Adachi S, Yoshimura M, et al. Solid tumor size on high-resolution computed tomography and maximum standardized uptake on positron emission tomography for new clinical T descriptors with T1 lung adenocarcinoma. Ann Oncol. 2013;24(9):2376–81.PubMedCrossRef Tsutani Y, Miyata Y, Nakayama H, Okumura S, Adachi S, Yoshimura M, et al. Solid tumor size on high-resolution computed tomography and maximum standardized uptake on positron emission tomography for new clinical T descriptors with T1 lung adenocarcinoma. Ann Oncol. 2013;24(9):2376–81.PubMedCrossRef
15.
Zurück zum Zitat Aokage K, Miyoshi T, Ishii G, Kusumoto M, Nomura S, Katsumata S, et al. Clinical and pathological staging validation in the eighth edition of the TNM classification for lung cancer: correlation between solid size on thin-section computed tomography and invasive size in pathological findings in the new T classification. J Thorac Oncol. 2017;12(9):1403–12.PubMedCrossRef Aokage K, Miyoshi T, Ishii G, Kusumoto M, Nomura S, Katsumata S, et al. Clinical and pathological staging validation in the eighth edition of the TNM classification for lung cancer: correlation between solid size on thin-section computed tomography and invasive size in pathological findings in the new T classification. J Thorac Oncol. 2017;12(9):1403–12.PubMedCrossRef
16.
Zurück zum Zitat Ahn H, Lee KW, Lee KH, Kim J, Kim K, Chung JH, et al. Effect of computed tomography window settings and reconstruction plane on 8th edition T-stage classification in patients with lung adenocarcinoma manifesting as a subsolid nodule. Eur J Radiol. 2018;98:130–5.PubMedCrossRef Ahn H, Lee KW, Lee KH, Kim J, Kim K, Chung JH, et al. Effect of computed tomography window settings and reconstruction plane on 8th edition T-stage classification in patients with lung adenocarcinoma manifesting as a subsolid nodule. Eur J Radiol. 2018;98:130–5.PubMedCrossRef
17.
Zurück zum Zitat Kakinuma R, Noguchi M, Ashizawa K, Kuriyama K, Maeshima AM, Koizumi N, et al. Natural history of pulmonary subsolid nodules: a prospective multicenter study. J Thorac Oncol. 2016;11(7):1012–28.PubMedCrossRef Kakinuma R, Noguchi M, Ashizawa K, Kuriyama K, Maeshima AM, Koizumi N, et al. Natural history of pulmonary subsolid nodules: a prospective multicenter study. J Thorac Oncol. 2016;11(7):1012–28.PubMedCrossRef
18.
Zurück zum Zitat Lee SM, Goo JM, Lee KH, Chung DH, Koh J, Park CM. CT findings of minimally invasive adenocarcinoma (MIA) of the lung and comparison of solid portion measurement methods at CT in 52 patients. Eur Radiol. 2015;25(8):2318–25.PubMedCrossRef Lee SM, Goo JM, Lee KH, Chung DH, Koh J, Park CM. CT findings of minimally invasive adenocarcinoma (MIA) of the lung and comparison of solid portion measurement methods at CT in 52 patients. Eur Radiol. 2015;25(8):2318–25.PubMedCrossRef
19.
Zurück zum Zitat Yanagawa M, Johkoh T, Noguchi M, Morii E, Shintani Y, Okumura M, et al. Radiological prediction of tumor invasiveness of lung adenocarcinoma on thin-section CT. Medicine. 2017;96(11):e6331.PubMedPubMedCentralCrossRef Yanagawa M, Johkoh T, Noguchi M, Morii E, Shintani Y, Okumura M, et al. Radiological prediction of tumor invasiveness of lung adenocarcinoma on thin-section CT. Medicine. 2017;96(11):e6331.PubMedPubMedCentralCrossRef
20.
Zurück zum Zitat Yanagawa M, Kusumoto M, Johkoh T, Noguchi M, Minami Y, Sakai F, et al. Radiologic-pathologic correlation of solid portions on thin-section CT images in lung adenocarcinoma: a multicenter study. Clin Lung Cancer. 2018;19(3):e303–12.PubMedCrossRef Yanagawa M, Kusumoto M, Johkoh T, Noguchi M, Minami Y, Sakai F, et al. Radiologic-pathologic correlation of solid portions on thin-section CT images in lung adenocarcinoma: a multicenter study. Clin Lung Cancer. 2018;19(3):e303–12.PubMedCrossRef
21.
Zurück zum Zitat Detterbeck FC, Chansky K, Groome P, Bolejack V, Crowley J, Shemanski L, et al. The IASLC Lung Cancer Staging Project: methodology and validation used in the development of proposals for revision of the stage classification of NSCLC in the forthcoming (Eighth) edition of the TNM classification of lung cancer. J Thorac Oncol. 2016;11(9):1433–46.PubMedCrossRef Detterbeck FC, Chansky K, Groome P, Bolejack V, Crowley J, Shemanski L, et al. The IASLC Lung Cancer Staging Project: methodology and validation used in the development of proposals for revision of the stage classification of NSCLC in the forthcoming (Eighth) edition of the TNM classification of lung cancer. J Thorac Oncol. 2016;11(9):1433–46.PubMedCrossRef
22.
Zurück zum Zitat Yang L, Wang S, Zhou Y, Lai S, Xiao G, Gazdar A, et al. Evaluation of the 7(th) and 8(th) editions of the AJCC/UICC TNM staging systems for lung cancer in a large North American cohort. Oncotarget. 2017;8(40):66784–95.PubMedPubMedCentralCrossRef Yang L, Wang S, Zhou Y, Lai S, Xiao G, Gazdar A, et al. Evaluation of the 7(th) and 8(th) editions of the AJCC/UICC TNM staging systems for lung cancer in a large North American cohort. Oncotarget. 2017;8(40):66784–95.PubMedPubMedCentralCrossRef
23.
Zurück zum Zitat Ginsberg RJ, Rubinstein LV. Randomized trial of lobectomy versus limited resection for T1 N0 non-small cell lung cancer: Lung Cancer Study Group. Ann Thorac Surg. 1995;60(3):615–22 (discussion 22-3).PubMedCrossRef Ginsberg RJ, Rubinstein LV. Randomized trial of lobectomy versus limited resection for T1 N0 non-small cell lung cancer: Lung Cancer Study Group. Ann Thorac Surg. 1995;60(3):615–22 (discussion 22-3).PubMedCrossRef
24.
Zurück zum Zitat Bao F, Ye P, Yang Y, Wang L, Zhang C, Lv X, et al. Segmentectomy or lobectomy for early stage lung cancer: a meta-analysis. Eur J Cardio-Thorac Surg. 2014;46(1):1–7.CrossRef Bao F, Ye P, Yang Y, Wang L, Zhang C, Lv X, et al. Segmentectomy or lobectomy for early stage lung cancer: a meta-analysis. Eur J Cardio-Thorac Surg. 2014;46(1):1–7.CrossRef
25.
Zurück zum Zitat Cao C, Chandrakumar D, Gupta S, Yan TD, Tian DH. Could less be more?-A systematic review and meta-analysis of sublobar resections versus lobectomy for non-small cell lung cancer according to patient selection. Lung Cancer (Amsterdam, Netherlands). 2015;89(2):121–32.CrossRef Cao C, Chandrakumar D, Gupta S, Yan TD, Tian DH. Could less be more?-A systematic review and meta-analysis of sublobar resections versus lobectomy for non-small cell lung cancer according to patient selection. Lung Cancer (Amsterdam, Netherlands). 2015;89(2):121–32.CrossRef
26.
Zurück zum Zitat El-Sherif A, Gooding WE, Santos R, Pettiford B, Ferson PF, Fernando HC, et al. Outcomes of sublobar resection versus lobectomy for stage I non-small cell lung cancer: a 13-year analysis. Ann Thorac Surgery. 2006;82(2):408–15 (discussion 15-6).CrossRef El-Sherif A, Gooding WE, Santos R, Pettiford B, Ferson PF, Fernando HC, et al. Outcomes of sublobar resection versus lobectomy for stage I non-small cell lung cancer: a 13-year analysis. Ann Thorac Surgery. 2006;82(2):408–15 (discussion 15-6).CrossRef
27.
Zurück zum Zitat Okami J, Ito Y, Higashiyama M, Nakayama T, Tokunaga T, Maeda J, et al. Sublobar resection provides an equivalent survival after lobectomy in elderly patients with early lung cancer. Ann Thorac Surg. 2010;90(5):1651–6.PubMedCrossRef Okami J, Ito Y, Higashiyama M, Nakayama T, Tokunaga T, Maeda J, et al. Sublobar resection provides an equivalent survival after lobectomy in elderly patients with early lung cancer. Ann Thorac Surg. 2010;90(5):1651–6.PubMedCrossRef
28.
Zurück zum Zitat Cao J, Xu J, He Z, Yuan P, Huang S, Lv W, et al. Prognostic impact of lymphadenectomy on outcomes of sublobar resection for stage IA non-small cell lung cancer ≤2 cm. J. Thorac. Cardiovasc Surg. 2018;156(2):796–805.PubMedCrossRef Cao J, Xu J, He Z, Yuan P, Huang S, Lv W, et al. Prognostic impact of lymphadenectomy on outcomes of sublobar resection for stage IA non-small cell lung cancer ≤2 cm. J. Thorac. Cardiovasc Surg. 2018;156(2):796–805.PubMedCrossRef
29.
Zurück zum Zitat Liu Y, Huang C, Liu H, Chen Y, Li S. Sublobectomy versus lobectomy for stage IA (T1a) non-small-cell lung cancer: a meta-analysis study. World J Surg Oncol. 2014;12:138.PubMedPubMedCentralCrossRef Liu Y, Huang C, Liu H, Chen Y, Li S. Sublobectomy versus lobectomy for stage IA (T1a) non-small-cell lung cancer: a meta-analysis study. World J Surg Oncol. 2014;12:138.PubMedPubMedCentralCrossRef
30.
Zurück zum Zitat Speicher PJ, Gu L, Gulack BC, Wang X, D’Amico TA, Hartwig MG, et al. Sublobar resection for clinical stage IA non-small-cell lung cancer in the United States. Clin Lung Cancer. 2016;17(1):47–55.PubMedCrossRef Speicher PJ, Gu L, Gulack BC, Wang X, D’Amico TA, Hartwig MG, et al. Sublobar resection for clinical stage IA non-small-cell lung cancer in the United States. Clin Lung Cancer. 2016;17(1):47–55.PubMedCrossRef
31.
Zurück zum Zitat Yendamuri S, Dhillon SS, Groman A, Dy G, Dexter E, Picone A, et al. Effect of the number of lymph nodes examined on the survival of patients with stage I non-small cell lung cancer who undergo sublobar resection. J Thorac Cardiovasc Surg. 2018;156(1):394–402.PubMedCrossRef Yendamuri S, Dhillon SS, Groman A, Dy G, Dexter E, Picone A, et al. Effect of the number of lymph nodes examined on the survival of patients with stage I non-small cell lung cancer who undergo sublobar resection. J Thorac Cardiovasc Surg. 2018;156(1):394–402.PubMedCrossRef
32.
Zurück zum Zitat Altorki NK, Wang X, Wigle D, Gu L, Darling G, Ashrafi AS, et al. Perioperative mortality and morbidity after sublobar versus lobar resection for early-stage non-small-cell lung cancer: post hoc analysis of an international, randomised, phase 3 trial (CALGB/Alliance 140503). Lancet Respir Med. 2018;6(12):915–24.PubMedPubMedCentralCrossRef Altorki NK, Wang X, Wigle D, Gu L, Darling G, Ashrafi AS, et al. Perioperative mortality and morbidity after sublobar versus lobar resection for early-stage non-small-cell lung cancer: post hoc analysis of an international, randomised, phase 3 trial (CALGB/Alliance 140503). Lancet Respir Med. 2018;6(12):915–24.PubMedPubMedCentralCrossRef
33.
Zurück zum Zitat Nakamura K, Saji H, Nakajima R, Okada M, Asamura H, Shibata T, et al. A phase III randomized trial of lobectomy versus limited resection for small-sized peripheral non-small cell lung cancer (JCOG0802/WJOG4607L). Jpn J Clin Oncol. 2010;40(3):271–4.PubMedCrossRef Nakamura K, Saji H, Nakajima R, Okada M, Asamura H, Shibata T, et al. A phase III randomized trial of lobectomy versus limited resection for small-sized peripheral non-small cell lung cancer (JCOG0802/WJOG4607L). Jpn J Clin Oncol. 2010;40(3):271–4.PubMedCrossRef
Metadaten
Titel
New T1 classification
verfasst von
Peter M. F. Lin
Michael K. Hsin
Publikationsdatum
02.11.2019
Verlag
Springer Singapore
Erschienen in
General Thoracic and Cardiovascular Surgery / Ausgabe 7/2020
Print ISSN: 1863-6705
Elektronische ISSN: 1863-6713
DOI
https://doi.org/10.1007/s11748-019-01233-0

Weitere Artikel der Ausgabe 7/2020

General Thoracic and Cardiovascular Surgery 7/2020 Zur Ausgabe

Wie erfolgreich ist eine Re-Ablation nach Rezidiv?

23.04.2024 Ablationstherapie Nachrichten

Nach der Katheterablation von Vorhofflimmern kommt es bei etwa einem Drittel der Patienten zu Rezidiven, meist binnen eines Jahres. Wie sich spätere Rückfälle auf die Erfolgschancen einer erneuten Ablation auswirken, haben Schweizer Kardiologen erforscht.

Hinter dieser Appendizitis steckte ein Erreger

23.04.2024 Appendizitis Nachrichten

Schmerzen im Unterbauch, aber sonst nicht viel, was auf eine Appendizitis hindeutete: Ein junger Mann hatte Glück, dass trotzdem eine Laparoskopie mit Appendektomie durchgeführt und der Wurmfortsatz histologisch untersucht wurde.

Mehr Schaden als Nutzen durch präoperatives Aussetzen von GLP-1-Agonisten?

23.04.2024 Operationsvorbereitung Nachrichten

Derzeit wird empfohlen, eine Therapie mit GLP-1-Rezeptoragonisten präoperativ zu unterbrechen. Eine neue Studie nährt jedoch Zweifel an der Notwendigkeit der Maßnahme.

Ureterstriktur: Innovative OP-Technik bewährt sich

19.04.2024 EAU 2024 Kongressbericht

Die Ureterstriktur ist eine relativ seltene Komplikation, trotzdem bedarf sie einer differenzierten Versorgung. In komplexen Fällen wird dies durch die roboterassistierte OP-Technik gewährleistet. Erste Resultate ermutigen.

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.