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Wie viel Staging braucht der Mensch?

  • Leitthema
  • Published:
Der Pneumologe Aims and scope

Zusammenfassung

Das gegenwärtige Staging- und TNM-System, das zuletzt 1997 revidiert wurde, wartet aufgrund sich verbessernder Behandlungsprognosen für einzelne Patientengruppen als auch einer immer besseren Kenntnis pathologisch-anatomischer Prognosefaktoren beim Bronchialkarzinom auf eine weitere Erneuerung. Insbesondere lymphogen fortgeschrittene Tumoren, T4- und M1-Situationen sind bis dato teilweise nicht differenziert genug erfasst, was für eine kleine, aber bedeutsame Patientengruppe an der Grenze zwischen kurativer und palliativer Therapie unzureichend erscheint. Maßgeblich für das individuelle Staging sollte ein zurückhaltender, abgestufter Ansatz sein, der stets die therapeutischen Konsequenzen im Auge hat. Innovative Stagingverfahren wie die Positronenemissionstomographie müssen angesichts überwiegend palliativer Therapieansätze auf eine breitere klinische Erfordernis hin als auch im Kosten-Nutzen-Vergleich noch differenzierter bewertet werden als bisher.

Abstract

The present staging and TNM system for lung cancer is under debate. After revision in 1997, the prognoses of subgroups of patients have improved due to advanced therapeutic concepts, and a deeper insight has been attained into prognostic factors based on pathological anatomy. Especially tumours with lymphogenic spread, T4 and M1 situations are described insufficiently, which could be meaningful for a small but important subgroup of patients who may or may not profit from a curative approach. The individual staging should be based on a sparing stepwise algorithm always keeping the therapeutic consequences in mind. Innovative staging procedures such as positron emission tomography require further evaluation on their use for the large group of palliatively treated patients, as well as cost-benefit aspects.

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  1. HELIOS Klinikum Emil von Behring, Lungenklinik Heckeshorn Berlin

    N. Schönfeld

  2. HELIOS Klinikum Emil von Behring, Lungenklinik Heckeshorn, Zum Heckeshorn 33, 14109 , Berlin

    N. Schönfeld

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  1. N. Schönfeld
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Schönfeld, N. Wie viel Staging braucht der Mensch?. Pneumologe 2, 118–122 (2005). https://doi.org/10.1007/s10405-005-0031-6

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  • DOI: https://doi.org/10.1007/s10405-005-0031-6

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