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Weichtteiltumoren

Allgemein-klinische Aspekte – chirurgische und medikamentöse Therapie

Soft tissue tumors

General clinical—surgical and pharmacological therapy

  • Leitthema
  • Published:
Der Onkologe Aims and scope

Zusammenfassung

Hintergrund

Maligne Weichteiltumoren sind sehr seltene bösartige Neubildungen mesenchymalen Ursprungs. Dies stellt nicht nur eine diagnostische, sondern auch eine therapeutische Herausforderung dar.

Ziel

Ziel ist die Darstellung allgemein-klinischer Aspekte sowie aktueller Strategien zur Diagnostik und Therapie von malignen Weichteiltumoren.

Material und Methoden

Der Beitrag ist ein Übersichtsartikel, der auf der Auswertung aktueller Literatur sowie Erfahrungen der Autoren basiert.

Ergebnisse

Maligne Weichteiltumoren sind am häufigsten in den Extremitäten lokalisiert, kommen aber auch abdominell und reptroperitoneal vor. Tumorgröße, hoher Malignitätsgrad und tiefe Lokalisation sind als Prognosefaktoren etabliert. Magnetresonanz- und Computertomographie sind die diagnostischen Methoden der Wahl. Das chirurgische Ziel ist die vollständige chirurgische Entfernung des Primärtumors. Eine adjuvante Chemotherapie und/oder Radiatio sollten bei Hochrisikopatienten diskutiert werden. Als palliative Therapieoptionen stehen Adriamycin, Ifosfamid sowie neuere Wirkstoffe wie Trabectedin und Pazopanib zur Verfügung.

Schlussfolgerungen

Die Therapie maligner Weichteiltumoren setzt ein interdisziplinäres Vorgehen voraus. Die Patienten sollten in einem spezialisierten Zentrum vorgestellt werden. Die Therapieziele werden in einer interdisziplinären Tumorkonferenz zwischen operativen Disziplinen, Strahlentherapie, Radiologie und internistischer Onkologie abgestimmt.

Abstract

Background

Malignant soft tissue tumors are very rare malignancies of mesenchymal origin and are a diagnostic as well as a therapeutic challenge.

Objective

Discussion of general clinical aspects and current strategies for diagnostics and therapy of malignant soft tissue tumors.

Material and methods

Review article based on the current literature and authors’ experience.

Results

Malignant soft tissue tumors are most frequently localized in the extremities but also occur in the abdomen and retroperitoneum. Tumor size, high histopathological grade and deep tumor localization are well established prognostic factors. Magnetic resonance imaging and computed tomography are the diagnostic methods of choice. At initial diagnosis, the surgical goal is complete resection of the primary tumor. Adjuvant chemotherapy and/or radiotherapy need to be discussed in cases of a high-risk situation. Palliative therapy options are doxorubicin, ifosfamide as well as newer agents, such as trebectedin and pazopanib.

Conclusion

For the therapy of soft tissue sarcomas an interdisciplinary approach is essential. Patient care should be referred to a specialized medical center. The therapeutic goals need to be discussed in an interdisciplinary tumor board between the fields of surgery, radiotherapy, radiology and medical oncology.

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Einhaltung ethischer Richtlinien

Interessenkonflikt. E. Schalk, B. Garlipp, C.J. Bruns und T. Fischer geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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Authors and Affiliations

  1. Klinik für Hämatologie und Onkologie, Zentrum für Innere Medizin, Universitätsklinikum, Otto-von-Guericke-Universität Magdeburg, Leipziger Str. 44, 39120, Magdeburg, Deutschland

    E. Schalk &  T. Fischer

  2. Klinik für Allgemein-, Viszeral- und Gefäßchirurgie, Universitätsklinikum, Otto-von-Guericke-Universität Magdeburg, Magdeburg, Deutschland

    B. Garlipp & C.J. Bruns

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  1. E. Schalk
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Correspondence to T. Fischer.

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Schalk, E., Garlipp, B., Bruns, C. et al. Weichtteiltumoren. Onkologe 21, 1147–1161 (2015). https://doi.org/10.1007/s00761-014-2885-x

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  • DOI: https://doi.org/10.1007/s00761-014-2885-x

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