Solide Tumoren im Kindesalter

Pediatric solid tumors

Zusammenfassung

Hintergrund

Maligne Erkrankungen sind bei Kindern insgesamt selten. Mit einer Inzidenz von 13,7 Neuerkrankungen auf 100.000 Kinder pro Jahr ist in Deutschland zu rechnen. Unter diesen dominieren mit etwa 46 % Leukämien und Lymphome. Mit etwa 20 % folgen die malignen Erkrankungen des zentralen Nervensystems. Dann folgen in absteigender Reihe Tumoren des sympathischen Nervensystems, Weichteilsarkome, Nierentumoren, Knochentumoren und Keimzelltumoren. Mehr als 90 % aller an Krebs erkrankten Kinder und Jugendlichen in Deutschland werden nach einheitlichen Standards behandelt. Dazu werden sie in die kontinuierlich durchgeführten Therapieoptimierungsstudien eingeschlossen, welche die gesamte Behandlung einschließlich der chirurgischen Therapie umfassen.

Ziel

Ziel dieser Übersichtsarbeit ist die Darstellung aktueller studiengerechter Behandlungsprinzipien solider Tumoren im Kindesalter unter besonderer Berücksichtigung der operativen Therapie.

Material und Methoden

Die Arbeit basiert auf selektiven Recherchen in der Datenbank PubMed zu den einzelnen Entitäten.

Ergebnisse

Die chirurgische Lokaltherapie hat entscheidenden Einfluss auf das Überleben von Kindern mit Weichteilsarkomen. Neuroblastome sind die häufigsten extrakraniellen soliden Tumoren bei Kindern und sehr komplex hinsichtlich ihrer Tumorbiologie und der anatomischen Lokalisationen. Hepatoblastome stellen die häufigsten primär malignen Lebertumoren im Kindesalter dar. Die aktuelle Stratifizierung (CHIC, Children’s Hepatic Tumors International Collaboration) sieht ausdrücklich die histologische Diagnosesicherung vor Therapiebeginn vor. Die Fortschritte in der interdisziplinären Therapie des Wilms-Tumors bis hin zu einer durchschnittlichen Überlebensrate von über 90 % sind das Ergebnis umfassender internationaler Studien.

Abstract

Background

Cancer in children is rare with an estimated incidence of 13.7 new cases per 100,000 children a year in Germany. Among these, leukemia and lymphoma are predominant at about 46%. Cancer of the central nervous system accounts for about 20%, followed in decreasing order by tumors of the sympathetic nervous system, soft tissue sarcoma, tumors of the kidney, bone tumors and germ cell tumors. More than 90% of all children and adolescents in Germany who have developed cancer are treated according to uniform standards and are included in therapy optimization studies, which cover the entire therapy spectrum, including surgical treatment.

Objective

This overview aims at portraying principles of treatment according to current study data in pediatric solid tumors with special consideration of surgical treatment.

Methods

This paper is based upon selective literature searches for each entity in the database PubMed.

Results

Local surgical treatment has a crucial impact upon the survival of children with soft tissue sarcoma. Neuroblastomas are the most common extracranial solid tumor in children and are very complex in terms of tumor biology and anatomic location. Hepatoblastomas are the most common primary malignant liver tumors in children. Current stratification (CHIC, Children’s Hepatic Tumors International Collaboration) explicitly requires histological diagnosis prior to starting treatment. Comprehensive international studies have resulted in an improvement of interdisciplinary therapy of Wilms tumor with a mean survival rate of more than 90%.

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Correspondence to Prof. Dr. med. F. Eckoldt.

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Interessenkonflikt

J. Fuchs, S. W. Warmann und F. Eckoldt 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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Fuchs, J., Warmann, S.W. & Eckoldt, F. Solide Tumoren im Kindesalter. Onkologe (2021). https://doi.org/10.1007/s00761-021-00930-x

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Schlüsselwörter

  • Weichteilsarkom
  • Neuroblastom
  • Hepatoblastom
  • Wilms-Tumor
  • Risikobeurteilung

Keywords

  • Soft tissue sarcoma
  • Neuroblastoma
  • Hepatoblastoma
  • Wilms tumor
  • Risk assessment