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Maßgeschneiderte Chirurgie in der Behandlung gastroösophagealer Tumoren

Tailored surgery in the treatment of gastroesophageal cancer

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best practice onkologie Aims and scope

Zusammenfassung

Die chirurgischen Optionen und insbesondere die perioperativen Therapien haben sich bei gastroösophagealen Karzinomen erheblich weiterentwickelt. Durch kurative multimodale Therapiekonzepte bei lokal fortgeschrittenen Karzinomen kann mittlerweile eine 5‑Jahres-Überlebensrate von nahezu 50 % erreicht werden. In Tumorboards und chirurgischen Fallbesprechungen stellt sich daher vermehrt die Frage, welche Art der Therapie individuellen Patienten mit ihren Vorerkrankungen die besten onkologischen und funktionellen Ergebnisse ermöglicht. Dabei gilt es, sorgfältig abzuwägen, ob in Zukunft auch organerhaltende Therapien in Betracht kommen oder in welcher Form minimal-invasive oder robotische Operationen Vorteile bieten können. Gleichzeitig verschieben sich gegenwärtig die Grenzen der operativen und onkologischen Therapie, um auch kurative Behandlungen für vorerkrankte Patienten oder Patienten mit einer oligometastatischen Erkrankung zu ermöglichen. Mit der Integration künstlicher Intelligenz in Entscheidungsprozesse stehen zunehmend neue Möglichkeiten der Informationsverarbeitung zur Verfügung, um in Zukunft noch mehr Daten in unsere Entscheidungsfindung einbeziehen zu können.

Abstract

The surgical options and particularly perioperative treatment, have significantly advanced in the case of gastroesophageal cancer. This progress enables a 5-year survival rate of nearly 50% to be achieved through curative multimodal treatment concepts for locally advanced cancer. Therefore, in tumor boards and surgical case discussions the question increasingly arises regarding the type of treatment that provides optimal oncological and functional outcomes for individual patients with pre-existing diseases. It is therefore essential to carefully assess whether organ-preserving treatment might also be considered in the future or in what way minimally invasive or robotic surgery can offer advantages. Simultaneously, the boundaries of surgical and oncological treatment are currently being shifted in order to enable curative forms of treatment for patients with pre-existing conditions or those with oligometastatic diseases. With the integration of artificial intelligence into decision-making processes, new possibilities for information processing are increasingly becoming available to incorporate even more data into making decisions in the future.

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Authors and Affiliations

  1. Klinik und Poliklinik für Allgemein‑, Viszeral‑, Tumor- und Transplantationschirurgie, Uniklinik Köln, Kerpenerstr. 62, 50937, Köln, Deutschland

    Thomas Schmidt, Hans F. Fuchs, Michael N. Thomas, Dolores T. Müller, Leandra Lukomski, Matthias Scholz & Christiane J. Bruns

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  2. Hans F. Fuchs
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Correspondence to Thomas Schmidt.

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T. Schmidt, H.F. Fuchs, M.N. Thomas, D.T. Müller, L. Lukomski, M. Scholz und C.J. Bruns geben an, dass kein Interessenkonflikt besteht.

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Dieser Beitrag erschien zuerst in Chirurgie 2024 https://doi.org/10.1007/s00104-024-02056-3

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Schmidt, T., Fuchs, H.F., Thomas, M.N. et al. Maßgeschneiderte Chirurgie in der Behandlung gastroösophagealer Tumoren. best practice onkologie 19, 122–129 (2024). https://doi.org/10.1007/s11654-024-00566-4

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