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Therapie des hepatozellulären Karzinoms

Therapy of hepatocellular carcinoma

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Zusammenfassung

Das hepatozelluläre Karzinom (HCC) ist mittlerweile die häufigste Todesursache bei Patienten mit Leberzirrhose. Es ist damit zurechnen, dass die Inzidenz in den kommenden Jahren auch in der westlichen Welt weiter steigt. Aufgrund einer unzureichenden Überwachung von Risikopatienten wird die Erkrankung häufig erst in einem fortgeschrittenen Stadium diagnostiziert. Im Zusammenspiel mit der in den meisten Fällen zugrunde liegenden Leberzirrhose resultieren hieraus die eingeschränkten Behandlungsoptionen und die schlechte Prognose vieler Patienten. Umso wichtiger ist eine stadiengerechte Beurteilung und interdisziplinäre Therapieentscheidung an erfahrenen Zentren. Unter Berücksichtigung der potenziell kurativen (Resektion, Lebertransplantation, lokale Ablation) und palliativen Therapieansätze (transarterielle Verfahren, Sorafenib) ist ein individualisiertes Gesamtkonzept möglich. Es ist zu hoffen, dass sich die Prognose von Patienten mit HCC durch eine verbesserte Prävention, konsequente Überwachung, multimodale Therapiekonzepte und eine Ausweitung der personalisierten Medizin in naher Zukunft deutlich verbessern wird.

Abstract

Today, hepatocellular carcinoma (HCC) represents the leading cause of death in patients with liver cirrhosis; in most western countries the incidence is also expected to increase further. Due to insufficient surveillance of patients at risk, most cases are diagnosed in an intermediate to advanced stage, leading—together with the underlying liver cirrhosis—to limited therapeutic options and a dismal prognosis. Therefore, classification according to stage and interdisciplinary treatment decisions in experienced centers are of paramount importance to provide an individualized treatment plan when considering potentially curative (resection, liver transplantation, local ablation) and palliative (transarterial approaches, sorafenib) treatment options. There is hope that the prognosis of patients with HCC can be improved in the near future by better prevention, stringent surveillance, multimodality treatment approaches, and an expansion of personalized medicine.

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Einhaltung ethischer Richtlinien

Interessenkonflikt. M.A. Wörns ist als Referent und Berater für Bayer Health Care und Lilly sowie als Referent für Bristol-Myers Squibb tätig. R. Klöckner ist als Referent für Bayer Health Care, Bristol-Myers Squibb und Terumo tätig. A. Weinmann ist als Referent und Berater für Bayer Health Care und als Referent für Bristol-Myers Squibb tätig. P.R. Galle ist als Referent und Berater für Bayer Health Care, Bristol-Myers Squibb und Lilly tätig. Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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Authors and Affiliations

  1. I. Medizinische Klinik und Poliklinik, Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Langenbeckstr. 1, 55131, Mainz, Deutschland

    M.A. Wörns, A. Weinmann & P.R. Galle

  2. Klinik und Poliklinik für Diagnostische und Interventionelle Radiologie, Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Mainz, Deutschland

    R. Klöckner

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  1. M.A. Wörns
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  2. R. Klöckner
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  3. A. Weinmann
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  4. P.R. Galle
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Correspondence to M.A. Wörns.

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Wörns, M., Klöckner, R., Weinmann, A. et al. Therapie des hepatozellulären Karzinoms. Internist 55, 23–30 (2014). https://doi.org/10.1007/s00108-013-3318-4

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