Skip to main content
Erschienen in: Annals of Surgical Oncology 5/2010

01.05.2010 | Gastrointestinal Oncology

Suitability of 7th UICC N Stage for Predicting the Overall Survival of Gastric Cancer Patients After Curative Resection in China

verfasst von: Jingyu Deng, MD, Han Liang, MD, Dan Sun, MS, Dianchang Wang, MD, Yi Pan, MD

Erschienen in: Annals of Surgical Oncology | Ausgabe 5/2010

Einloggen, um Zugang zu erhalten

Abstract

Background

Metastatic lymph node count (MLNC) is the most intensively prognostic indicator of gastric cancer. How to efficiently evaluate the best classification of MLNC is unclear. The purpose of this study was to evaluate the overall survival (OS) prediction of new UICC N stage in gastric cancer after curative surgery.

Materials and Methods

Data from 456 patients who underwent curative resection were used to choose the most efficient classification of MLNC for evaluation the OS of gastric cancer.

Results

Using univariate analysis, both the N stage of 7th edition UICC TNM classification (7th UICC N stage) and N stage of 5th/6th edition UICC TNM classification (5th/6th UICC N stage) were associated with the OS of gastric cancer after curative surgery. However, Cox regression multivariate analysis showed the 7th UICC N stage was an independent factor for predicting the OS of gastric cancer instead of the 5th/6th UICC N stage. Besides, we used the case-control matched fashion for further validation of the superiority of the 7th UICC N stage in prognostic prediction of gastric cancer. Last, we adopted the cut-point survival analysis to determine the most appropriate cutoffs for MLNC of all gastric cancer patients after curative surgery. We demonstrated the cutoff of 7th UICC N stage was similar to that produced from the cut-point survival analysis.

Conclusion

The 7th UICC N stage appears to provide a reliable prognostic category of MLNC of gastric cancer than the 5th/6th UICC N stage, and it is the efficiently prognostic indicator of gastric cancer after curative surgery.
Literatur
1.
Zurück zum Zitat Abe N, Watanabe T, Suzuki K, Machida H, Toda H, Nakaya Y, et al. Risk factors predictive of lymph node metastasis in depressed early gastric cancer. Am J Surg. 2002;183:168–72.CrossRefPubMed Abe N, Watanabe T, Suzuki K, Machida H, Toda H, Nakaya Y, et al. Risk factors predictive of lymph node metastasis in depressed early gastric cancer. Am J Surg. 2002;183:168–72.CrossRefPubMed
2.
Zurück zum Zitat Yamaguchi T, Sano T, Katai H, Sasako M, Maruyama K. Node positive mucosal gastric cancer: a follow-up study. Jpn J Clin Oncol. 2001;31:153–6.CrossRefPubMed Yamaguchi T, Sano T, Katai H, Sasako M, Maruyama K. Node positive mucosal gastric cancer: a follow-up study. Jpn J Clin Oncol. 2001;31:153–6.CrossRefPubMed
3.
Zurück zum Zitat Chen CY, Wu CW, Lo SS, Hsieh MC, Lui WY, Shen KH. Peritoneal carcinomatosis and lymph node metastasis are prognostic indicators in patients with Borrmann type IV gastric carcinoma. Hepatogastroenterology. 2002;49:874–7.PubMed Chen CY, Wu CW, Lo SS, Hsieh MC, Lui WY, Shen KH. Peritoneal carcinomatosis and lymph node metastasis are prognostic indicators in patients with Borrmann type IV gastric carcinoma. Hepatogastroenterology. 2002;49:874–7.PubMed
4.
Zurück zum Zitat Yokota T, Kunii Y, Teshima S, Yamada Y, Saito T, Takahashi M, et al. Significant prognostic factors in patients with early gastric cancer. Int Surg. 2000;85:286–90.PubMed Yokota T, Kunii Y, Teshima S, Yamada Y, Saito T, Takahashi M, et al. Significant prognostic factors in patients with early gastric cancer. Int Surg. 2000;85:286–90.PubMed
5.
Zurück zum Zitat Manfe AZ, Segalina P, Maffei Faccioli A. Prognostic factors in gastric cancer. Our experience and review of the literature. Minerva Chir. 2000;55:299–305.PubMed Manfe AZ, Segalina P, Maffei Faccioli A. Prognostic factors in gastric cancer. Our experience and review of the literature. Minerva Chir. 2000;55:299–305.PubMed
6.
Zurück zum Zitat Omejc M, Juvan R, Jelenc F, Repse S. Lymph node metastases in gastric cancer: correlation between new and old UICC TNM classification. Int Surg. 2001;86:14–9.PubMed Omejc M, Juvan R, Jelenc F, Repse S. Lymph node metastases in gastric cancer: correlation between new and old UICC TNM classification. Int Surg. 2001;86:14–9.PubMed
7.
Zurück zum Zitat Kajitani T. Japanese Research Society for Gastric Cancer: the general rules for the gastric cancer study in surgery and pathology. I. Jpn J Surg. 1981;11:127–139.CrossRefPubMed Kajitani T. Japanese Research Society for Gastric Cancer: the general rules for the gastric cancer study in surgery and pathology. I. Jpn J Surg. 1981;11:127–139.CrossRefPubMed
8.
Zurück zum Zitat Japanese Gastric Cancer Association. Japanese Classification of Gastric Carcinoma, 2nd English ed. Gastric Cancer. 1998;1:10–4. Japanese Gastric Cancer Association. Japanese Classification of Gastric Carcinoma, 2nd English ed. Gastric Cancer. 1998;1:10–4.
9.
Zurück zum Zitat Wu CW, Hsieh MC, Lo SS, Shen KH, Lui WY, P’eng FK. Comparison of the UICC/AJCC 1992 and 1997 pN categories for gastric cancer patients after surgery. Hepatogastroenterology. 2001;48:279–84.PubMed Wu CW, Hsieh MC, Lo SS, Shen KH, Lui WY, P’eng FK. Comparison of the UICC/AJCC 1992 and 1997 pN categories for gastric cancer patients after surgery. Hepatogastroenterology. 2001;48:279–84.PubMed
10.
Zurück zum Zitat Katai H, Yoshimura K, Maruyama K, Sasako M, Sano T. Evaluation of the New International Union Against Cancer TNM staging for gastric carcinoma. Cancer. 2000;88:1796–800.CrossRefPubMed Katai H, Yoshimura K, Maruyama K, Sasako M, Sano T. Evaluation of the New International Union Against Cancer TNM staging for gastric carcinoma. Cancer. 2000;88:1796–800.CrossRefPubMed
11.
Zurück zum Zitat Kunisaki C, Shimada H, Nomura M, Matsuda G, Otsuka Y, Ono H, et al. Comparative evaluation of gastric carcinoma staging: Japanese classification versus new American joint committee on cancer/international union against cancer classification. Ann Surg Oncol. 2004;11:203–6.CrossRefPubMed Kunisaki C, Shimada H, Nomura M, Matsuda G, Otsuka Y, Ono H, et al. Comparative evaluation of gastric carcinoma staging: Japanese classification versus new American joint committee on cancer/international union against cancer classification. Ann Surg Oncol. 2004;11:203–6.CrossRefPubMed
12.
Zurück zum Zitat Fujii K, Isozaki H, Okajima K, Nomura E, Niki M, Sako S, et al. Clinical evaluation of lymph node metastasis in gastric cancer defined by the fifth edition of the TNM classification in comparison with the Japanese system. Br J Surg. 1999;86:685–9.CrossRefPubMed Fujii K, Isozaki H, Okajima K, Nomura E, Niki M, Sako S, et al. Clinical evaluation of lymph node metastasis in gastric cancer defined by the fifth edition of the TNM classification in comparison with the Japanese system. Br J Surg. 1999;86:685–9.CrossRefPubMed
13.
Zurück zum Zitat Ichikura T, Tomimatsu S, Uefuji K, Kimura M, Uchida T, Morita D, et al. Evaluation of the New American Joint Committee on Cancer/International Union Against Cancer Classification of lymph node metastasis from gastric carcinoma in comparison with the Japanese classification. Cancer. 1999;86:5538.CrossRef Ichikura T, Tomimatsu S, Uefuji K, Kimura M, Uchida T, Morita D, et al. Evaluation of the New American Joint Committee on Cancer/International Union Against Cancer Classification of lymph node metastasis from gastric carcinoma in comparison with the Japanese classification. Cancer. 1999;86:5538.CrossRef
14.
Zurück zum Zitat Adachi Y, Kamakura T, Mori M, Baba H, Maehara Y, Sugimachi K. Prognostic significance of the number of positive lymph nodes in gastric carcinoma. Br J Surg. 1994;81:414–6.CrossRefPubMed Adachi Y, Kamakura T, Mori M, Baba H, Maehara Y, Sugimachi K. Prognostic significance of the number of positive lymph nodes in gastric carcinoma. Br J Surg. 1994;81:414–6.CrossRefPubMed
15.
Zurück zum Zitat Pan W, Ishii H, Ebihara Y, Gobe G. Prognostic use of growth characteristics of early gastric cancer and expression patterns of apoptotic, cell proliferation, and cell adhesion proteins. J Surg Oncol. 2003;82:104–10.CrossRefPubMed Pan W, Ishii H, Ebihara Y, Gobe G. Prognostic use of growth characteristics of early gastric cancer and expression patterns of apoptotic, cell proliferation, and cell adhesion proteins. J Surg Oncol. 2003;82:104–10.CrossRefPubMed
16.
Zurück zum Zitat Coburn NG, Swallow CJ, Kiss A, Law C. Significant regional variation in adequacy of lymph node assessment and survival in gastric cancer. Cancer. 2006;107:2143–51.CrossRefPubMed Coburn NG, Swallow CJ, Kiss A, Law C. Significant regional variation in adequacy of lymph node assessment and survival in gastric cancer. Cancer. 2006;107:2143–51.CrossRefPubMed
17.
Zurück zum Zitat Deng JY, Liang H, Sun D, Zhan HJ, Wang XN. The appropriate cutoffs of positive lymph nodes to evaluate the prognosis of gastric cancer patients. J Surg Oncol. 2008;98:343–8.CrossRefPubMed Deng JY, Liang H, Sun D, Zhan HJ, Wang XN. The appropriate cutoffs of positive lymph nodes to evaluate the prognosis of gastric cancer patients. J Surg Oncol. 2008;98:343–8.CrossRefPubMed
18.
Zurück zum Zitat Fleming ID, Cooper JS, Murphy GP, Sullivan BO, Sobin LH, Yarbro JW, et al., eds. American Joint Committee on Cancer: Cancer Staging Manual. Philadelphia: Lippincott-Raven; 1997:71–6. Fleming ID, Cooper JS, Murphy GP, Sullivan BO, Sobin LH, Yarbro JW, et al., eds. American Joint Committee on Cancer: Cancer Staging Manual. Philadelphia: Lippincott-Raven; 1997:71–6.
19.
Zurück zum Zitat Sobin LH, Wittekind CH, eds. TNM Classification of Malignant Tumors. 5th ed. International Union Against Cancer (UICC). New York: Wiley; 1997:59–62. Sobin LH, Wittekind CH, eds. TNM Classification of Malignant Tumors. 5th ed. International Union Against Cancer (UICC). New York: Wiley; 1997:59–62.
20.
Zurück zum Zitat Greene FL, Page AL, Fleming ID, Fritz A, Balch CM, Haller DG, et al., eds. American Joint Committee on Cancer: AJCC Cancer Staging Manual, 6th ed. New York: Springer; 2002:99–106. Greene FL, Page AL, Fleming ID, Fritz A, Balch CM, Haller DG, et al., eds. American Joint Committee on Cancer: AJCC Cancer Staging Manual, 6th ed. New York: Springer; 2002:99–106.
21.
Zurück zum Zitat Sobin L, Gospodarowicz M, Wittekind C, eds. TNM Classification of Malignant Tumours. 7th ed. International Union Against Cancer (UICC). New York: Wiley; 2009. Sobin L, Gospodarowicz M, Wittekind C, eds. TNM Classification of Malignant Tumours. 7th ed. International Union Against Cancer (UICC). New York: Wiley; 2009.
22.
Zurück zum Zitat Smith DD, Schwarz RR, Schwartz RE. Impact of total lymph node count on staging and survival after gastrectomy for gastric cancer: data from a large US-Population Database. J Clin Oncol. 2005;23:7114–24.CrossRefPubMed Smith DD, Schwarz RR, Schwartz RE. Impact of total lymph node count on staging and survival after gastrectomy for gastric cancer: data from a large US-Population Database. J Clin Oncol. 2005;23:7114–24.CrossRefPubMed
23.
Zurück zum Zitat Roukos DH. Current status and future perspectives in gastric cancer management. Cancer Treat Rev. 2000;26:243–55.CrossRefPubMed Roukos DH. Current status and future perspectives in gastric cancer management. Cancer Treat Rev. 2000;26:243–55.CrossRefPubMed
24.
Zurück zum Zitat Dhar DK, Kubota H, Tachibana M, Kinugasa S, Masunaga R, Shibakita M, et al. Prognosis of T4 gastric carcinoma patients: an appraisal of aggressive surgical treatment. J Surg Oncol. 2001;76:278–82.CrossRefPubMed Dhar DK, Kubota H, Tachibana M, Kinugasa S, Masunaga R, Shibakita M, et al. Prognosis of T4 gastric carcinoma patients: an appraisal of aggressive surgical treatment. J Surg Oncol. 2001;76:278–82.CrossRefPubMed
25.
Zurück zum Zitat Dhar DK, Kubota H, Tachibana M, Kotoh T, Tabara H, Watanabe R, et al. Long-term survival of transmural advanced gastric carcinoma following curative resection: multivariate analysis of prognostic factors. World J Surg. 2000;24:588–93.CrossRefPubMed Dhar DK, Kubota H, Tachibana M, Kotoh T, Tabara H, Watanabe R, et al. Long-term survival of transmural advanced gastric carcinoma following curative resection: multivariate analysis of prognostic factors. World J Surg. 2000;24:588–93.CrossRefPubMed
26.
Zurück zum Zitat Gotoda T, Sasako M, Ono H, Katai H, Sano T, Shimoda T. Evaluation of the necessity for gastrectomy with lymph node dissection for patients with submucosal invasive gastric cancer. Br J Surg. 2001;88:444–9.CrossRefPubMed Gotoda T, Sasako M, Ono H, Katai H, Sano T, Shimoda T. Evaluation of the necessity for gastrectomy with lymph node dissection for patients with submucosal invasive gastric cancer. Br J Surg. 2001;88:444–9.CrossRefPubMed
27.
Zurück zum Zitat Kunisaki C, Akiyama H, Nomura M, Matsuda G, Otsuka Y, Ono H, et al. Comparison of surgical results of D2 versus D3 gastrectomy (para-aortic lymph node dissection) for advanced gastric carcinoma: a multi-institutional study. Ann Surg Oncol. 2006;13:659–67.CrossRefPubMed Kunisaki C, Akiyama H, Nomura M, Matsuda G, Otsuka Y, Ono H, et al. Comparison of surgical results of D2 versus D3 gastrectomy (para-aortic lymph node dissection) for advanced gastric carcinoma: a multi-institutional study. Ann Surg Oncol. 2006;13:659–67.CrossRefPubMed
28.
Zurück zum Zitat Ohno S, Tachibana M, Shibakita M, Dhar DK, Yoshimura H, Kinugasa S, et al. Prognostic significance of Fas and Fas ligand system-associated apoptosis in gastric cancer. Ann Surg Oncol. 2000;7:750–7.CrossRefPubMed Ohno S, Tachibana M, Shibakita M, Dhar DK, Yoshimura H, Kinugasa S, et al. Prognostic significance of Fas and Fas ligand system-associated apoptosis in gastric cancer. Ann Surg Oncol. 2000;7:750–7.CrossRefPubMed
29.
Zurück zum Zitat Okajima K. Prognostic factors of gastric cancer patients-a study by univariate and multivariate analysis. Jpn J Gastroenterol Surg. 1997;30:700–11. Okajima K. Prognostic factors of gastric cancer patients-a study by univariate and multivariate analysis. Jpn J Gastroenterol Surg. 1997;30:700–11.
30.
Zurück zum Zitat Aiko T, Sasako M. The new Japanese Classification of Gastric Carcinoma: points to be revised. Gastric Cancer. 1998;1:25–30.CrossRefPubMed Aiko T, Sasako M. The new Japanese Classification of Gastric Carcinoma: points to be revised. Gastric Cancer. 1998;1:25–30.CrossRefPubMed
31.
Zurück zum Zitat Bando E, Yonemura Y, Taniguchi K, Fushida S, Fujimura T, Miwa K. Outcome of ratio of lymph node metastasis in gastric carcinoma. Ann Surg Oncol. 2002;9:775–84.CrossRefPubMed Bando E, Yonemura Y, Taniguchi K, Fushida S, Fujimura T, Miwa K. Outcome of ratio of lymph node metastasis in gastric carcinoma. Ann Surg Oncol. 2002;9:775–84.CrossRefPubMed
32.
Zurück zum Zitat Okusa T, Nakane Y, Boku T, Takada H, Yamamura M, Hioki K, et al. Quantitative analysis of nodal involvement with respect to survival rate after curative gastrectomy for carcinoma. Surg Gynecol Obstet. 1990;170:488–94.PubMed Okusa T, Nakane Y, Boku T, Takada H, Yamamura M, Hioki K, et al. Quantitative analysis of nodal involvement with respect to survival rate after curative gastrectomy for carcinoma. Surg Gynecol Obstet. 1990;170:488–94.PubMed
33.
Zurück zum Zitat Zhan YQ, Sun XW, Li W, Chen YB, Xu L, Guan YX, et al. Multivariate prognostic analysis in gastric carcinoma patients after radical operation. Ai Zheng. 2005;24:596–9.PubMed Zhan YQ, Sun XW, Li W, Chen YB, Xu L, Guan YX, et al. Multivariate prognostic analysis in gastric carcinoma patients after radical operation. Ai Zheng. 2005;24:596–9.PubMed
34.
Zurück zum Zitat Jaehne J, Meyer HJ, Maschek H, Geerlings H, Bruns E, Pichlmayr R. Lymphadenectomy in gastric adenocarcinoma. A prospective and prognostic study. Arch Surg. 1992;127:290–4.PubMed Jaehne J, Meyer HJ, Maschek H, Geerlings H, Bruns E, Pichlmayr R. Lymphadenectomy in gastric adenocarcinoma. A prospective and prognostic study. Arch Surg. 1992;127:290–4.PubMed
35.
Zurück zum Zitat Ikeguchi M, Murakami D, Kanaji S, Ohro S, Maeta Y, Yamaguchi KI, et al. Lymph node metastasis of gastric cancer: comparison of Union International Contra Cancer and Japanese systems. ANZ J Surg. 2004;74:852–4.CrossRefPubMed Ikeguchi M, Murakami D, Kanaji S, Ohro S, Maeta Y, Yamaguchi KI, et al. Lymph node metastasis of gastric cancer: comparison of Union International Contra Cancer and Japanese systems. ANZ J Surg. 2004;74:852–4.CrossRefPubMed
36.
Zurück zum Zitat D’Ugo D, Pacelli F, Persiani R, Pende V, Ianni A, Papa V, et al. Impact of the latest TNM classification for gastric cancer: retrospective analysis on 94 D2 gastrectomy. World J Surg. 2002;26:672–7.CrossRefPubMed D’Ugo D, Pacelli F, Persiani R, Pende V, Ianni A, Papa V, et al. Impact of the latest TNM classification for gastric cancer: retrospective analysis on 94 D2 gastrectomy. World J Surg. 2002;26:672–7.CrossRefPubMed
37.
Zurück zum Zitat Huang B, Zheng X, Wang Z, Wang M, Dong Y, Zhao B, et al. Prognostic significance of the number of metastatic lymph nodes: Is UICC/TNM node classification perfectly suitable for early gastric cancer? Ann Surg Oncol. 2009;16:61–7.CrossRefPubMed Huang B, Zheng X, Wang Z, Wang M, Dong Y, Zhao B, et al. Prognostic significance of the number of metastatic lymph nodes: Is UICC/TNM node classification perfectly suitable for early gastric cancer? Ann Surg Oncol. 2009;16:61–7.CrossRefPubMed
38.
Zurück zum Zitat Roviello F, Rossi S, Marrelli D, Pedrazzani C, Corso G, Vindigni C, et al. Number of lymph node metastases and its prognostic significance in early gastric cancer: a multicenter Italian study. J Surg Oncol. 2006;94:274–80.CrossRef Roviello F, Rossi S, Marrelli D, Pedrazzani C, Corso G, Vindigni C, et al. Number of lymph node metastases and its prognostic significance in early gastric cancer: a multicenter Italian study. J Surg Oncol. 2006;94:274–80.CrossRef
39.
Zurück zum Zitat Gunji Y, Suzuki T, Hori S, Hayashi H, Matsubara H, Shimada H, et al. Prognostic significance of the number of metastatic lymph nodes in early gastric cancer. Dig Surg. 2003;20:148–53.CrossRefPubMed Gunji Y, Suzuki T, Hori S, Hayashi H, Matsubara H, Shimada H, et al. Prognostic significance of the number of metastatic lymph nodes in early gastric cancer. Dig Surg. 2003;20:148–53.CrossRefPubMed
40.
Zurück zum Zitat Wu CW, Hsieh MC, Lo SS, Tsay SH, Lui WY, P’eng FK. Relation of number of positive lymph nodes to the prognosis of patients with primary gastric adenocarcinoma. Gut. 1996;38:525–7.CrossRefPubMed Wu CW, Hsieh MC, Lo SS, Tsay SH, Lui WY, P’eng FK. Relation of number of positive lymph nodes to the prognosis of patients with primary gastric adenocarcinoma. Gut. 1996;38:525–7.CrossRefPubMed
41.
Zurück zum Zitat Ichikura T, Tomimatsu S, Okusa Y, Uefuji K, Tamakuma S. Comparison of the prognostic significance between the number of metastatic lymph nodes and nodal stage based on their location in patients with gastric cancer. J Clin Oncol. 1993;11:1894–900.PubMed Ichikura T, Tomimatsu S, Okusa Y, Uefuji K, Tamakuma S. Comparison of the prognostic significance between the number of metastatic lymph nodes and nodal stage based on their location in patients with gastric cancer. J Clin Oncol. 1993;11:1894–900.PubMed
42.
Zurück zum Zitat Zhang X, David IW, Glyn GJ. Lymph node metastases of adenocarcinoma of the esophagus and esophagogastric junction. Chin Med J. 2007;120:2268–70.PubMed Zhang X, David IW, Glyn GJ. Lymph node metastases of adenocarcinoma of the esophagus and esophagogastric junction. Chin Med J. 2007;120:2268–70.PubMed
Metadaten
Titel
Suitability of 7th UICC N Stage for Predicting the Overall Survival of Gastric Cancer Patients After Curative Resection in China
verfasst von
Jingyu Deng, MD
Han Liang, MD
Dan Sun, MS
Dianchang Wang, MD
Yi Pan, MD
Publikationsdatum
01.05.2010
Verlag
Springer-Verlag
Erschienen in
Annals of Surgical Oncology / Ausgabe 5/2010
Print ISSN: 1068-9265
Elektronische ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-010-0939-x

Weitere Artikel der Ausgabe 5/2010

Annals of Surgical Oncology 5/2010 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.