Therapie von Thymomen und Thymuskarzinomen View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2017-09

AUTHORS

Michael Ried, Michael Rechenmacher, Barbara Dietl, Alexander Marx, Okka W. Hamer, Berthold Schalke, Lukas Kirzinger, Hans-Stefan Hofmann

ABSTRACT

Thymome und Thymuskarzinome (TK) zählen zu den häufigsten primären malignen Raumforderungen im vorderen Mediastinum. In diesem Übersichtsartikel sollen insbesondere diagnostische Verfahren und multimodale Therapiekonzepte dargestellt werden. Selektive Literaturrecherche über Medline (Schlüsselwörter: thymoma, thymic carcinoma, advanced thymoma) und interdisziplinäre, klinische Erfahrungen. Die therapeutisch und prognostisch relevante Beschreibung der Ausbreitung (Staging) von Thymomen und TK erfolgt aktuell zweigleisig nach der Masaoka-Koga- und der neuen TNM-Klassifikation, die histologische Einteilung nach der WHO-Klassifikation. Die komplette chirurgische Tumorresektion (R0) inklusive Thymus (Thymom‑/Thymektomie) ist die Standardtherapie bei primär resektablen Tumoren und der entscheidende prognostische Faktor. Bei fortgeschrittenen bzw. primär nichtresektablen Tumoren wird ein multimodales Therapiekonzept bestehend aus Chemotherapie, Operation und Strahlentherapie empfohlen. Bei Patienten mit refraktären Thymomen und TK werden Immun-Checkpoint-Inhibitoren aktuell klinisch getestet. Die präoperative Diagnostik bei Mediastinaltumoren umfasst die Computer- und Magnetresonanztomographie sowie die histologische Untersuchung von Stanzbiopsien, falls insbesondere Lymphome differenzialdiagnostisch in Betracht kommen. Die komplette Tumorresektion bildet bei Thymomen und TK weiterhin die Therapie der ersten Wahl. Eine interdisziplinäre Indikationsstellung und eine multimodale Behandlung in einem erfahrenen Zentrum können sowohl bei Patienten mit lokal oder pleural fortgeschrittenen Thymomen bzw. TK als auch bei Patienten mit Tumorrezidiven die Prognose verbessern. More... »

PAGES

206-214

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s11654-017-0037-7

DOI

http://dx.doi.org/10.1007/s11654-017-0037-7

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1091407634


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