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Gastrointestinale Stromatumoren und Sarkome

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Facharztwissen Viszeral- und Allgemeinchirurgie
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Zusammenfassung

Sarkome sind seltene Tumoren, die weniger als 1 % der neudiagnostizierten Malignome des Erwachsenen jährlich ausmachen. Weichteilsarkome können in jedem Teil des Körpers vorkommen; in abnehmender Inzidenz werden sie wie folgt diagnostiziert: Extremitäten (59 %), Rumpf (19 %), Retroperitoneum (13 %), Kopf und Hals (9 %). Gastrointestinale Stromatumore (GIST) sind auch seltene Neoplasien, die sich von den mesenchymatösen Zellen des gastrointestinalen Traktes entwickeln. Die meisten GIST werden im Magen diagnostiziert. Die Rezidivrate beider Tumorgruppen (Sarkome > GIST) ist relativ hoch einzuschätzen. Die Autoren dieses Kapitels stellen sowohl die epidemiologischen, klinischen und diagnostischen Grundlagen als auch die Prinzipien der operativen Therapie dieser Tumoren dar. Die Strategien der nichtoperativen Therapie dieser Entitäten werden diskutiert.

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Literatur

Literatur zu Abschnitt 14.1

  • Balachandran VP, DeMatteo RP (2013) Targeted therapy for cancer: the GIST model. Surg Oncol Clin N. Am 22: 805–821

    Article  PubMed  PubMed Central  Google Scholar 

  • Bamboat ZM, DeMatteo RP (2012) Updates on the management of gastrointestinal stromal tumors. Surg Oncol Clin N Am 21: 301–316

    Article  PubMed  PubMed Central  Google Scholar 

  • Bamboat ZM, DeMatteo RP (2014) Metastasectomy for gastrointestinal stromal tumors. J Surg Oncol 109: 23–27

    Article  PubMed  Google Scholar 

  • Feig BW, Ching CD (2012) The MD Anderson Surgical oncology handbook, 5th edn. Lippincott, Williams and Wilkins, Philadelphia, Baltimore, New York, London

    Google Scholar 

  • Fletcher CD, Berman JJ, Corless C et al. (2002a) Diagnosis of gastrointestinal stromal tumors: a consensus approach. Hum Pathol 33: 459–465

    Article  PubMed  Google Scholar 

  • Miettinen M, Lasota J (2001) Gastrointestinal stromal tumors – definition, clinical, histological, immunohistochemical, and moleculargenetic features and differential diagnosis. Virchows Arch 438: 1–12

    Article  CAS  PubMed  Google Scholar 

Literatur zu Abschnitt 14.2

  • Bannasch H, Eisenhardt SU, Grosu AL, Heinz J, Momeni A, Stark GB (2011) The diagnosis and treatment of soft tissue sarcomas of the limbs. Dtsch Arztebl Int 108: 32–38

    PubMed  PubMed Central  Google Scholar 

  • Canter RJ, Smith CA, Martinez SR Goodnight JE Jr, Bold RJ, Wisner DH (2013) Extremity soft tissue tumor surgery by surgical specialty: a comparison of case volume among oncology and non-oncology-designated surgeons. J Surg Oncol 108: 142–147

    Article  PubMed  Google Scholar 

  • Daigeler A, Kuhnen C, Moritz R, Stricker I, Goertz O, Tilkorn D, Steinstraesser L, Steinau HU, Lehnhardt M (2009) Lymph node metastases in soft tissue sarcomas: a single center analysis of 1,597 patients. Langenbecks Arch Surg. 394: 321–329

    Article  CAS  PubMed  Google Scholar 

  • Fletcher CDM, Unni KK, Mertens F (2002b) Pathology and genetics of tumours of soft tissue and bone, In: WHO Classification of Tumours, International Agency for Research on Cancer. IARC Press, Lyon

    Google Scholar 

  • Issels RD, Lindner LH, Verweij J, Wust P, Reichardt P, Schem BC, Abdel-Rahman S, Daugaard S, Salat C, Wendtner CM, Vujaskovic Z, Wessalowski R, Jauch KW, Dürr HR, Ploner F, Baur-Melnyk A, Mansmann U, Hiddemann W, Blay JY, Hohenberger P; European Organisation for Research and Treatment of Cancer Soft Tissue and Bone Sarcoma Group (EORTC-STBSG); European Society for Hyperthermic Oncology (ESHO) (2010) Neo-adjuvant chemotherapy alone or with regional hyperthermia for localised high-risk soft-tissue sarcoma: a randomised phase 3 multicentre study. Lancet Oncol 11: 561–570

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Jo VY, Fletcher CD (2014) WHO classification of soft tissue tumours: an update based on the 2013 (4th) edition. Pathology 46: 95–104

    Article  CAS  PubMed  Google Scholar 

  • Kraus-Tiefenbacher US, Van Kampen M (2015) Current trends in radiotherapy following surgical resection of soft-tissue sarcoma of the extremities and trunk. Handchir Mikrochir Plast Chir 47: 128–133

    Article  CAS  PubMed  Google Scholar 

  • Lahat G, Tuvin D, Wei C, Anaya DA, Bekele BN, Lazar AJ, Pisters PW, Lev D, Pollock RE (2008) New perspectives for staging and prognosis in soft tissue sarcoma. Ann Surg Oncol 10: 2739–2748

    Article  Google Scholar 

  • Le Cesne A, Ouali M, Leahy MG, Santoro A, Hoekstra HJ, Hohenberger P, Van Coevorden F, Rutkowski P, Van Hoesel R, Verweij J, Bonvalot S, Steward WP, Gronchi A, Hogendoorn PC, Litiere S, Marreaud S, Blay JY, Van Der Graaf WT (2014) Doxorubicin-based adjuvant chemotherapy in soft tissue sarcoma: pooled analysis of two STBSG-EORTC phase III clinical trials. Ann Oncol 25: 2425–2432

    Article  CAS  PubMed  Google Scholar 

  • O’Sullivan B1, Davis AM, Turcotte R, Bell R, Catton C, Chabot P, Wunder J, Kandel R, Goddard K, Sadura A, Pater J, Zee B (2002) Preoperative versus postoperative radiotherapy in soft-tissue sarcoma of the limbs: a randomised trial. Lancet 359: 2235–2241

    Article  PubMed  Google Scholar 

  • Pisters PW, Harrison LB, Leung DH, Woodruff JM, Casper ES, Brennan MF (1996) Long-term results of a prospective randomized trial of adjuvant brachytherapy in soft tissue sarcoma. J Clin Oncol 3: 859–856

    Google Scholar 

  • Steinau HU, Daigeler A, Langer S, Steinsträsser L, Hauser J, Goertz O, Lehnhardt M (2010) Limb salvage in malignant tumors. Semin Plast Surg 24: 18–33

    Article  PubMed  PubMed Central  Google Scholar 

Literatur zu Abschnitt 14.3

  • Bartlett EK, Roses RE, Meise C et al. (2014) Preoperative radiation for retroperitoneal sarcoma is not associated with increased early postoperative morbidity. J Surg Oncol 109: 606–611

    Article  PubMed  Google Scholar 

  • Bonvalot S, Rivoire M, Castaing M et al. (2009) Primary retroperitoneal sarcomas: a multivariate analysis of surgical factors associated with local control. J Clin Oncol 2009; 27: 31–37

    Google Scholar 

  • Bonvalot S, Miceli R, Berselli M et al. (2010) Aggressive surgery in retroperitoneal soft tissue sarcoma carried out at high-volume centers is safe and is associated with improved local control. Ann Surg Oncol 17: 1507–1514

    Article  PubMed  Google Scholar 

  • Canter RJ, Qin LX, Ferrone CR et al. (2008) Why do patients with low-grade soft tissue sarcoma die? Ann Surg Oncol 15: 3550–3560

    Article  PubMed  PubMed Central  Google Scholar 

  • Cormier JN, Pollock RE (2004) Soft tissue sarcomas. CA Cancer J Clin 54: 94–109

    Article  PubMed  Google Scholar 

  • Dematteo RP, Ballman KV, Antonescu CR et al. (2009) Adjuvant imatinib mesylate after resection of localised, primary gastrointestinal stromal tumour: a randomised, double-blind, placebo-controlled trial. Lancet 373: 1097–1104

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Dimitrakopoulou-Strauss A, Strauss LG, Schwarzbach M et al. (2001) Dynamic PET 18F-FDG studies in patients with primary and recurrent soft-tissue sarcomas: impact on diagnosis and correlation with grading. J Nucl Med 42: 713–720

    CAS  PubMed  Google Scholar 

  • Donahue TR, Kattan MW, Nelson SD et al. (2010) Evaluation of neoadjuvant therapy and histopathologic response in primary, high-grade retroperitoneal sarcomas using the sarcoma nomogram. Cancer 116: 3883–3891

    Article  PubMed  Google Scholar 

  • Feig BW, Ching CD (2012) The MD Anderson Surgical Oncology Handbook, 5th edn. Lippincott, Williams & Wilkins, Philadelphia Baltimore New York London

    Google Scholar 

  • Folpe AL, Lyles RH, Sprouse JT et al. (2000) (F-18) fluorodeoxyglucose positron emission tomography as a predictor of pathologic grade and other prognostic variables in bone and soft tissue sarcoma. Clin Cancer Res 6: 1279–1287

    CAS  PubMed  Google Scholar 

  • Gaspar N, Hawkins DS, Dirksen U et al. (2015) Ewing sarcoma: current management and future approaches through collaboration. J Clin Oncol 33 (27): 3036–3046

    Article  CAS  PubMed  Google Scholar 

  • Gilbeau L, Kantor G, Stoeckle E et al. (2002) Surgical resection and radiotherapy for primary retroperitoneal soft tissue sarcoma. Radiother Oncol 65: 137–143

    Article  PubMed  Google Scholar 

  • Gronchi A, Casali PG, Fiore M et al. (2004) Retroperitoneal soft tissue sarcomas: patterns of recurrence in 167 patients treated at a single institution. Cancer 100: 2448–2455

    Article  PubMed  Google Scholar 

  • Gronchi A, De Paoli A, Dani C et al. (2014) Preoperative chemo-radiation therapy for localised retroperitoneal sarcoma: a phase I-II study from the Italian Sarcoma Group Eur J Cancer 50: 784–792

    Google Scholar 

  • Gronchi A, Miceli R, Allard MA et al. (2015) Personalizing the approach to retroperitoneal soft tissue sarcoma: histology-specific patterns of failure and postrelapse outcome after primary extended resection. Ann Surg Oncol 22: 1447–1454

    Article  PubMed  Google Scholar 

  • Hassan I, Park SZ, Donohue JH et al. (2004) Operative management of primary retroperitoneal sarcomas: a reappraisal of an institutional experience. Ann Surg 239: 244–250

    Article  PubMed  PubMed Central  Google Scholar 

  • Helman LJ, Meltzer P (2003) Mechanisms of sarcoma development. Nat Rev Cancer 3: 685–694

    Article  CAS  PubMed  Google Scholar 

  • Heslin MJ, Lewis JJ, Nadler E et al. (1997) Prognostic factors associated with long-term survival for retroperitoneal sarcoma: implications for management. J Clin Oncol 15: 2832–2839

    CAS  PubMed  Google Scholar 

  • Issels RD, Lindner LH, Verweij J et al. (2010) Neo-adjuvant chemotherapy alone or with regional hyperthermia for localised high-risk soft-tissue sarcoma: a randomised phase 3 multicentre study. Lancet Oncol 11: 561–570

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Lehnert T, Cardona S, Hinz U et al. (2009) Primary and locally recurrent retroperitoneal soft-tissue sarcoma: local control and survival. Eur J Surg Oncol 35: 986–993

    Article  CAS  PubMed  Google Scholar 

  • Lewis JJ, Leung D, Woodruff JM et al. (1998) Retroperitoneal soft-tissue sarcoma: analysis of 500 patients treated and followed at a single institution. Ann Surg 228: 355–365

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • McBride SM, Raut CP, Lapidus M et al. (2013) Locoregional recurrence after preoperative radiation therapy for retroperitoneal sarcoma: adverse impact of multifocal disease and potential implications of dose escalation. Ann Surg Oncol 20: 2140–2147

    Article  PubMed  Google Scholar 

  • Mehren M von, Randall RL, Benjamin RS et al. (2014) Soft tissue sarcoma, version 2.2014. J Natl Compr Canc Netw 12: 473–483

    Google Scholar 

  • Mullinax JE, Zager JS, Gonzalez RJ (2011) Current diagnosis and management of retroperitoneal sarcoma. Cancer Control 18: 177–187

    PubMed  Google Scholar 

  • Mussi C, Colombo P, Bertuzzi A et al. (2011) Retroperitoneal sarcoma: is it time to change the surgical policy? Ann Surg Oncol 18: 2136–2142

    Article  PubMed  Google Scholar 

  • Nathan H, Raut CP, Thornton K, Herman JM et al. (2009) Predictors of survival after resection of retroperitoneal sarcoma: a population-based analysis and critical appraisal of the AJCC staging system. Ann Surg 250: 970–976

    Article  PubMed  PubMed Central  Google Scholar 

  • Nussbaum DP, Speicher PJ, Gulack BC et al. (2014) The effect of neoadjuvant radiation therapy on perioperative outcomes among patients undergoing resection of retroperitoneal sarcomas. Surg Oncol 23: 155–160

    Article  PubMed  PubMed Central  Google Scholar 

  • Paryani NN, Zlotecki RA, Swanson EL et al. Multimodality local therapy for retroperitoneal sarcoma. Int J Radiat Oncol Biol Phys 82: 1128–1134

    Google Scholar 

  • Pawlik TM, Pisters PW, Mikula L et al. (2006) Long-term results of two prospective trials of preoperative external beam radiotherapy for localized intermediateor high-grade retroperitoneal soft tissue sarcoma. Ann Surg Oncol 13: 508–517

    Article  PubMed  Google Scholar 

  • Porter GA, Baxter NN, Pisters PW (2006) Retroperitoneal sarcoma: a population-based analysis of epidemiology, surgery, and radiotherapy. Cancer 106: 1610–1616

    Article  PubMed  Google Scholar 

  • Russo P, Kim Y, Ravindran S et al. (1997) Nephrectomy during operative management of retroperitoneal sarcoma. Ann Surg Oncol 4: 421–424

    Article  CAS  PubMed  Google Scholar 

  • Sindelar WF, Kinsella TJ, Chen PW et al. (1993) Intraoperative radiotherapy in retroperitoneal sarcomas. Final results of a prospective, randomized, clinical trial. Arch Surg 128: 402–410

    Article  CAS  PubMed  Google Scholar 

  • Smith MJ, Ridgway PF, Catton CN et al. (2014) Combined management of retroperitoneal sarcoma with dose intensification radiotherapy and resection: long-term results of a prospective trial. Radiother Oncol 110: 165–171

    Article  PubMed  Google Scholar 

  • Taylor BS, Barretina J, Maki RG et al. (2011) Advances in sarcoma genomics and new therapeutic targets. Nat Rev Cancer 11: 541–557

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Tseng WH, Martinez SR, Tamurian RM et al. (2011) Contiguous organ resection is safe in patients with retroperitoneal sarcoma: An ACS-NSQIP analysis. J Surg Oncol 103: 390–394

    Article  PubMed  Google Scholar 

  • Tzeng CW, Fiveash JB, Popple RA et al. (2006) Preoperative radiation therapy with selective dose escalation to the margin at risk for retroperitoneal sarcoma. Cancer 2006; 107: 371–379

    Article  Google Scholar 

  • Wilkinson MJ, Martin JL, Khan AA et al. (2015) Percutaneous core needle biopsy in retroperitoneal sarcomas does not influence local recurrence or overall survival. Ann Surg Oncol 22: 853–858

    Article  CAS  PubMed  Google Scholar 

  • WHO (2002) World Health Organization Classification of Tumours, Pathology and Genetics of Tumours of Soft Tissue and Bone, Lyon

    Google Scholar 

  • Youssef E, Fontanesi J, Mott M et al. (2002) Long-term outcome of combined modality therapy in retroperitoneal and deep-trunk soft-tissue sarcoma: analysis of prognostic factors. Int J Radiat Oncol Biol Phys 54: 514–519

    Article  PubMed  Google Scholar 

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Oertli, D., Bannasch, H., Tampakis, A., Kettelhack, C. (2017). Gastrointestinale Stromatumoren und Sarkome. In: Billmann, F., Keck, T. (eds) Facharztwissen Viszeral- und Allgemeinchirurgie. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-48308-4_14

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