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Behandlungsstrategien beim Mundhöhlenkarzinom

Treatment strategies for oral cancer

  • Leitthema
  • Published:
Der Onkologe Aims and scope

Zusammenfassung

Hintergrund

Karzinome der Mundhöhle gehören zu den häufigsten Malignomen des Kopf- und Hals-Bereichs, wobei sie von den Oropharynxtumoren bezüglich ihrer Entstehung wie auch Behandlung deutlich abzugrenzen sind. Die Mundhöhle erlaubt eine einfache und frühzeitige Erkennung von Schleimhautveränderungen, was zur Konsequenz habe sollte, dass Betroffene zur weiteren Inspektion und Beurteilung einen Spezialisten aufsuchen. Dennoch stellen sich viele Patienten erst im fortgeschrittenen Stadium eines Mundhöhlenkarzinoms mit dann deutlich schlechterer Prognose vor.

Behandlungsprinzipien und Ergebnisse

Gerade kleinere Karzinome der Mundhöhle können heute mit einem guten Erhalt der Lebensqualität und guter Überlebenszeitprognose operativ behandelt werden. Dies setzt jedoch zum einen eine Resektion des Primärtumors mit ausreichendem Sicherheitsabstand, eine zervikale Lymphknotenausräumung und eine gute plastisch-chirurgische Rekonstruktion voraus.

Eine nur unvollständig mögliche Resektion des Karzinoms oder eine Filialisierung in die lokoregionalen Lymphknoten machen eine adjuvante Radiotherapie erforderlich. Im fortgeschrittenen Stadium kann es notwendig sein, diese durch eine Chemo- oder Immuntherapie zu ergänzen.

Schlussfolgerung

Bei differenzierter Therapiestrategie können Mundhöhlenkarzinome heute mit einem guten onkologischen und funktionellen Langzeitergebnis behandelt werden.

Abstract

Background

Oral cancer is one of the most frequent malignancies of the head and neck region, whereby it needs to be differentiated from oropharyngeal tumors, which have another origin and would be treated differently. The oral cavity enables an easy and early recognition of mucosal malignancies, the consequence of which is that patients should contact a specialist as soon as possible; however, many patients present in an advanced stage of the disease, which subsequently results in a worse prognosis.

Treatment concepts and results

Particularly small tumors in the oral cavity can nowadays be treated with a good preservation of the quality of life and an excellent survival prognosis; however, the prerequisites are a radical resection of the primary tumor with sufficient tumor-free margins, a dissection of the cervical lymph nodes and an adequate plastic reconstructive surgery. In the case of an incomplete resection of the tumor and metastases in the locoregional lymph nodes, adjuvant radiotherapy becomes necessary. In advanced stages it can even become necessary to supplement this with chemotherapy or immunotherapy.

Conclusion

By means of a differentiated approach oral cancer can nowadays be treated with good oncological and functional long-term results.

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Authors and Affiliations

  1. Klinik und Poliklinik für Mund‑, Kiefer- und Gesichtschirurgie, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Deutschland

    J. Hoffmann

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Hoffmann, J. Behandlungsstrategien beim Mundhöhlenkarzinom. Onkologe 25, 201–209 (2019). https://doi.org/10.1007/s00761-019-0522-4

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