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Active Surveillance

Strategie beim Nierenzellkarzinom?

Active surveillance

Concept for renal cell carcinoma?

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Zusammenfassung

Heutzutage werden > 80 % der Nierentumore zufällig im Rahmen der Abdomensonographie detektiert. Häufig sind hierdurch ältere Menschen mit erheblichen Komorbiditäten betroffen. Chirurgische Therapieoptionen, wie sie für die jüngeren Patienten zur Anwendung kommen, können in diesem Kollektiv nicht bedenkenlos eingesetzt werden, denn die perioperativen Risikofaktoren stellen in manchen Fällen eine größere Einschränkung der Lebenserwartung als das Risiko, an Tumorfolgen zu versterben, dar. In diesem Zusammenhang rückt das Konzept der aktiven Überwachung für das lokalisierte Nierenzellkarzinom eines älteren Patienten immer mehr ins Rampenlicht. Das Ziel der aktiven Überwachung ist es, dem Patienten die perioperativen Nebenwirkungen zu ersparen und das Tumorverhalten kontrolliert zu beobachten, ggf. mit der Möglichkeit einer verzögerten Intervention bei klinisch aggressiven Tumorcharakteristiken. In dieser Übersicht wird der aktuelle Stellenwert der Strategie beleuchtet.

Abstract

More than 80 % of renal cell carcinomas are currently being detected incidentally by ultrasonic imaging and often affect elderly patients with substantial comorbidities. Surgical options cannot be applied in this cohort as routinely as in younger patients, as in some cases the perioperative risk factors may outweigh the risk of tumor-related death. In this context the concept of active surveillance for localized renal cell cancer in elderly patients is becoming increasingly important. The aim of active surveillance is to avoid surgery-related adverse effects and to achieve a controlled observation of tumor behavior with an option of delayed intervention in cases of aggressive clinical tumor features. This review sheds light on the current status of this strategy.

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  1. Klinik für Urologie und Kinderurologie, Universitätsklinikum Frankfurt, Goethe-Universität, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Deutschland

    I. Tsaur, D. Schilling & A. Haferkamp

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  1. I. Tsaur
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  2. D. Schilling
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  3. A. Haferkamp
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Correspondence to I. Tsaur.

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Tsaur, I., Schilling, D. & Haferkamp, A. Active Surveillance. Urologe 52, 793–799 (2013). https://doi.org/10.1007/s00120-013-3197-2

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  • DOI: https://doi.org/10.1007/s00120-013-3197-2

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