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Molekulare und genetische Stratifizierung in der chirurgischen Onkologie

Molecular and genetic stratification in surgical oncology

Zusammenfassung

Hintergrund

Neue Technologien erlauben die immer genauere Einteilung von Tumoren anhand ihrer molekularen und genetischen Besonderheiten.

Ziele der Arbeit

Basierend auf aktuellen wissenschaftlichen Studien werden Status, Potenzial und Konzepte der molekularen und genetischen Stratifizierung in der chirurgischen Onkologie wiedergegeben.

Material und Methoden

In der vorliegenden Arbeit werden eine Auswertung und Zusammenfassung der aktuellen Literatur gegeben, basierend auf einer PubMed-Datenbankrecherche mit folgenden Schlagwörtern: Präzisionschirurgie, molekulare Stratifizierung, kolorektale Lebermetastasen, Magenkarzinom, Pankreaskarzinom.

Ergebnisse und Schlussfolgerungen

Das Wissen über molekulare Besonderheiten der einzelnen Tumorentitäten wächst rapide und ermöglicht eine Zuordnung individueller Tumoren zu spezifischen und therapierelevanten molekularen Subtypen. Aktuell findet die Stratifizierung einzelner Patienten anhand molekularer Parameter allerdings selten Eingang in die Indikationsstellung zur Operation gastrointestinaler Tumoren. Um einzelnen Patienten die jeweils bestmögliche Therapie anzubieten, sollten molekulare und genetische Tumorcharakteristika perspektivisch auch in Therapieentscheidungen in der chirurgischen Onkologie einfließen. Gezielte prospektive Studien sind notwendig, um molekulare und genetische Datenprofile zur Prognoseabschätzung nach Tumorresektionen nutzbar zu machen.

Abstract

Background

New technologies facilitate increasingly accurate subclassification of individual tumors based on molecular and genetic characteristics.

Objectives

Status, potential, and concepts of molecular and genetic stratification in surgical oncology are reviewed on the basis of currently available scientific evidence.

Materials and methods

Summary and evaluation of the recent literature according to a PubMed database search applying the following keywords: precision surgery, molecular stratification, colorectal liver metastases, gastric cancer, pancreatic cancer.

Results and conclusions

Knowledge on molecular characteristics of specific tumor entities continues to expand rapidly and enables the classification of individual tumors into specific and therapy-relevant molecular subtypes. However, the stratification of individual patients based on molecular parameters is currently rarely used for surgical decision-making in the treatment of gastrointestinal tumors. To offer each patient the best possible treatment option, molecular and genetic tumor characteristics should be integrated into therapeutic decisions in surgical oncology. Prospective studies are necessary to better utilize molecular and genetic data profiles for the estimation of prognosis after surgical tumor resection.

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Correspondence to Martin Schneider.

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Interessenkonflikt

N. Schleussner und M. Schneider 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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Schleussner, N., Schneider, M. Molekulare und genetische Stratifizierung in der chirurgischen Onkologie. Onkologe (2021). https://doi.org/10.1007/s00761-021-01051-1

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Schlüsselwörter

  • Patientenspezifische Modellierung
  • Präzisionsmedizin
  • Metastasierung
  • Magenkarzinom
  • Pankreaskarzinom

Keywords

  • Patient-specific modeling
  • Precision medicine
  • Metastasis
  • Gastric neoplasms
  • Pancreatic neoplasms