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Einfluss der Molekularpathologie auf die onkologische Chirurgie von Leber- und Gallengangstumoren

Influence of molecular pathology on oncological surgery of liver and bile duct tumors

Zusammenfassung

Hintergrund

Die Molekularpathologie dient zunehmend der Therapiesteuerung in der Onkologie. Etwa 25 % aller hepatozellulären Karzinome (HCCs) und 50 % der Cholangiokarzinome (CCAs) weisen bekannte krebsrelevante Mutationen auf, deren Einfluss auf die Behandlung dieser Tumoren noch nicht ausreichend verstanden ist.

Ziel der Arbeit

Die Evaluation der aktuellen Literatur über die molekularpathologischen Fortschritte beim HCC/CCA und deren möglicher Einfluss auf die onkologische Chirurgie.

Material und Methoden

Zunächst erfolgte eine Zusammenfassung der in PubMed und clinitrials.gov verfügbaren Literatur über die aktuell bekannten molekularen Biomarker beim HCC/CCA. Anhand dieser Daten wird der mögliche Einfluss dieser Biomarker auf die onkologische Chirurgie diskutiert.

Schlussfolgerung

Molekularpathologische Untersuchungen können zur Unterstützung der Tumortypisierung und Dignitätsbestimmung von HCCs/CCAs eingesetzt werden. Prädiktive molekulare Biomarker konnten sich in der regulären Diagnostik noch nicht etablieren, können aber zur erweiterten Therapieplanung eingesetzt werden.

Abstract

Background

Molecular pathology is increasingly being used to guide treatment in oncology. Approximately 25% of all hepatocellular carcinomas (HCC) and 50% of cholangiocarcinomas (CCA) present with known cancer-relevant mutations; however, the impact of the mutations on the treatment of these tumors is not yet sufficiently understood.

Purpose

To evaluate the current literature on molecular pathological advances in HCC/CCA and the potential impact on oncological surgery.

Material and methods

A comprehensive search of the available literature on currently known molecular biomarkers in HCC/CCA was performed in PubMed and clinitrials.gov. Following review, the potential impact of these biomarkers on oncological surgery was analyzed and is discussed.

Conclusion

Molecular pathological investigations can be used to support the classification of tumors and to determine the dignity of HCC/CCA. Predictive molecular biomarkers are not yet established in routine diagnostics but can be used to individualize advanced oncological treatment.

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Danksagung

Die Autoren danken Herrn Bernhard-Christian Münch für die Hilfe beim Erstellen des Manuskriptes.

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Correspondence to Andreas Pascher.

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Interessenkonflikt

M.A. Juratli, B. Struecker, S. Katou, M. H. Morguel und A. Pascher geben an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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Juratli, M.A., Struecker, B., Katou, S. et al. Einfluss der Molekularpathologie auf die onkologische Chirurgie von Leber- und Gallengangstumoren. Chirurg (2021). https://doi.org/10.1007/s00104-021-01495-6

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Schlüsselwörter

  • Personalisierte Medizin
  • Hepatozelluläres Karzinom
  • Cholangiokarzinome
  • Onkologische Chirurgie
  • Flüssigbiopsie

Keywords

  • Personalized medicine
  • Hepatocellular carcinoma
  • Cholangiocarcinoma
  • Surgical oncology
  • Liquid biopsy