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Bronchialkarzinom

Chirurgische Therapie

Lung cancer

Surgical therapy

  • Leitthema
  • Published:
Der Pneumologe Aims and scope

Zusammenfassung

Das Bronchialkarzinom ist die häufigste maligne Todesursache in der industrialisierten Welt. Die 5-Jahres-Überlebensrate von ca. 14% über alle Stadien und alle Therapieformen ist schlecht. Die alleinige thoraxchirurgische Behandlung bietet nur in den frühen Stadien eine echte Heilungschance. Die fortgeschrittenen Stadien sind eine interdisziplinäre Aufgabe mit multimodalem Behandlungskonzept, in der die Thoraxchirurgie einen Baustein der Behandlung darstellt. Als operative Standardverfahren gelten die Lobektomie, die Bilobektomie und die Pneumonektomie, während limitierte Resektionen nur als Ausnahme vorgenommen werden sollten. Bei der Operation muss immer eine systematische interlobäre und mediastinale Lymphknotendissektion durchgeführt werden. Die thoraxchirurgischen Standardresektionen können mit verschiedenen technischen Verfahren konventionell oder minimal-invasiv durchgeführt werden. In seltenen Fällen können neben der kurativen Zielsetzung chirurgische Maßnahmen mit palliativer Wirkung zum Einsatz kommen.

Abstract

Lung cancer is the leading cause of cancer death in the industrial world. The overall 5-year survival rate is about 14% for all stages, and all forms of therapy are poor. Only the early stages of disease (IA/IB) are potentially surgically curable. In advanced stages (II–III), thoracic surgery is integrated with multimodal treatment approaches . “Gold standard” surgery involves anatomic lobectomy or pneumonectomy with systematic mediastinal lymph node dissection. Limited resection should be the exception. Various technical possibilities for standard resection are possible using open thoracotomy or minimal-invasive video-assisted thoracic surgery. In rare conditions, surgical treatment for palliation could be necessary without curative intention.

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  1. Lungenzentrum, Klinik für Thoraxchirurgie, Klinikum Bremen-Ost

    E. Hecker

  2. Lungenzentrum, Klinik für Thoraxchirurgie, Klinikum Bremen-Ost, Züricher Straße 40, 28325, Bremen

    E. Hecker

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Hecker, E. Bronchialkarzinom. Pneumologe 2, 237–253 (2005). https://doi.org/10.1007/s10405-005-0050-3

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