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Prinzipien der Sarkomchirurgie

Principles of sarcoma surgery

  • Schwerpunkt: Sarkome
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Zusammenfassung

Weichgewebesarkome sind seltene Erkrankungen. Unabhängig von der Lokalisation ist die Chirurgie die wichtigste Behandlungsmethode der nicht metastasierten Erkrankung. Fortschritte in der onkologischen und rekonstruktiven Chirurgie haben gemeinsam mit dem Einsatz multimodaler Therapien stark funktionseinschränkende Operationen bei Extremitätensarkomen zu seltenen Eingriffen gemacht. Eine besondere Rolle spielt dabei das Verständnis für eine fokale marginale Resektion im multimodalen Behandlungskonzept. Bei retroperitonealen Sarkomen ist ein Lokalrezidiv lebensbedrohlich und die gezielte Mitresektion angrenzender Organe im Sinne einer Multiviszeralresektion hat sich als Standardoperation durchgesetzt. In diesem Artikel werden neben der chirurgischen Diagnostik und Therapieplanung die Operationsstrategie von Weichgewebesarkomen der Extremitäten und des Retroperitoneums diskutiert.

Abstract

Soft-tissue sarcomas are rare malignant tumors. Surgery remains the most important treatment modality. Neoadjuvant and/or adjuvant chemo- and radiotherapy may be administered to improve the local and systemic outcome. Advances in oncological and reconstructive surgery, combined with the use of multimodal therapies, have made mutilating surgery rare events in extremity sarcomas. In retroperitoneal sarcomas, local recurrences are life-threatening events and multivisceral resection has become the standard surgical procedure. The subjects of this review are diagnostics, multimodal therapy, and resection strategy from a surgical point of view.

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Authors and Affiliations

  1. Klinik für Allgemein‑, Viszeral- und Kinderchirurgie, Universitätsmedizin Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Deutschland

    J. Jakob

  2. Sektion Chirurgische Onkologie und Thoraxchirurgie, Chirurgische Klinik, Universitätsmedizin Mannheim, Th.-Kutzer-Ufer 1–3, 68163, Mannheim, Deutschland

    P. Hohenberger

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Correspondence to J. Jakob.

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Interessenkonflikt

J. Jakob und P. Hohenberger 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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M. Evert, Regensburg

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Jakob, J., Hohenberger, P. Prinzipien der Sarkomchirurgie. Pathologe 40, 431–435 (2019). https://doi.org/10.1007/s00292-019-0631-2

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