Thromboembolische Komplikationen und Thromboseprophylaxe bei fortgeschrittenen testikulären Keimzelltumoren

Die Onkologie - Testikuläre Keimzelltumoren (TGCT) stellen die häufigste Neoplasie des jungen Mannes dar. Die hohen Ansprechraten auf eine cisplatinbasierte Chemotherapie führt bei...     

Chirurgische Therapie im Stadium I und II des nichtkleinzelligen Lungenkarzinoms

Background

Despite modern diagnostics and multimodal treatment strategies, overall survival of lung cancer could not be significantly improved in recent decades. The majority of patients with non-small cell lung cancer (NSCLC) have distant metastases at the time of diagnosis (57%) and only approximately 40% of patients are in a potentially curable tumor stage.

Material and methods

A systematic literature search concerning original research and review articles on surgery of NSCLC in stages I and II was carried out in the PubMed database.

Results

For patients in an early tumor stage, stages I and II tumors according to the 8th edition of the Union for International Cancer Control (UICC) tumor stage classification, surgical removal of the tumor remains the therapeutic gold standard. By complete anatomical resection (lobectomy, bilobectomy or pneumonectomy) combined with a systematic mediastinal and hilar lymphadenectomy, 5?year survival rates of more than 80% in early stage IA and 48% in stage II can be achieved. In addition to open surgical resection, video-assisted, minimally invasive thoracoscopic (VATS) resection was successfully implemented worldwide for the treatment of NSCLC patients in stages I and II. For patients with stage II NSCLC, adjuvant chemotherapy was shown to improve the overall survival.

Discussion

Whether targeted therapies or immunotherapy in a neoadjuvant or adjuvant treatment modality further improve the survival of NSCLC patients in the multimodal treatment of early stage NSCLC, is currently under investigation in randomized studies.

     

Diagnostik und Therapie der chronischen myelomonozytären Leukämie im Jahr 2020

best practice onkologie - Die chronischen myelomonozytären Leukämien (CMML) sind klonale Stammzellerkrankungen mit persistierendem Nachweis einer Monozytose im peripheren Blut. Die...     

CUP – Internistische Therapie bei spezifischen Subgruppen

Subgroups of patients with cancer of unknown origin have a chance of curative treatment or more favorable prognosis. To identify these patients is important in the treatment of patients with cancer of unknown primary. Relevant subgroups are patients with resectable metastases, patients with squamous cell lymph node metastases in the neck, patients with melanoma of unknown primary or adenocarcinoma with immunohistochemistry typical for colon cancer, women with isolated axillary lymph node metastases or papillary-serous peritoneal carcinomatosis, and male patients with midline lymph node metastases or osteoblastic metastases. Patients of these subgroups benefit from treatment according to the patients with known primary, including multidisciplinary therapy based on evidence from retrospective research.     

Tumorassoziierte venöse Thromboembolie – Pathogenese,Diagnose, Prävention und Therapie

best practice onkologie - Bei Tumorpatienten sind tiefe Venenthrombosen und Lungenembolien – trotz angewandter primärpräventiver Maßnahmen – häufige, die...     

Aktueller Stand der Diagnostik und Therapie des nichtkleinzelligen Lungenkarzinoms (NSCLC) im Stadium III

Based on the considerable heterogeneity of patient subgroups in stage III non-small-cell lung cancer (NSCLC)—despite the slightly more differentiated 8th edition of the Union Internationale Contre le Cancer (UICC)/International Association for the Study of Lung Cancer (IASLC) staging classification—increasingly individualized treatment of these patients has become necessary. Initial interdisciplinary assessment of potential operability is a key factor for treatment selection. Standard treatment for the majority of stage III NSCLC patients is still concurrent chemoradiotherapy. However, based on the equivocal and clinically relevant positive results of the phase III PACIFIC trial, this treatment should be followed by consolidation therapy with durvalumab for 12 months in patients with proven PD-L1 expression in the tumor. In patients who are evaluated as potentially operable in interdisciplinary consensus, multimodality treatment protocols including definitive surgical resection of the tumor are still standard. Based on the positive data on immunotherapy in inoperable patients, there are now multiple interesting scenarios for integration of this new modality into the treatment of patients with localized disease, which should be carefully analyzed in well-designed prospective clinical trials.     

Erratum zu: Diagnostik und Therapie der chronischen myelomonozytären Leukämie im Jahr 2020

best practice onkologie - Ein Erratum zu dieser Publikation wurde veröffentlicht: https://doi.org/10.1007/s11654-020-00278-5     

Diagnostik und Therapie des cholangiozellulären Karzinoms

Cholangiocellular carcinomas (CCC) are classified based on the anatomical location into intrahepatic (iCCC), perihilar (pCCC) and distal (dCCC) subgroups with different features and therapeutic options. Modern imaging techniques including magnetic resonance cholangiopancreatography (MRCP) offer excellent noninvasive diagnostic options. After major hepatectomy for iCCC a median survival of 36-57 months could be observed. Radical en bloc resection with portal vein resection for pCCC exhibits superior 5-year survival rates of 58?%. After pancreatoduodenectomy for dCCC, 5-year survival rates of 27-33?% can be achieved. Endoscopy plays a major role in palliative stenting which can be combined with photodynamic therapy. Palliative chemotherapy offers a median survival of up to 13 months but there is still little evidence in support of neoadjuvant or adjuvant therapy regimes.     

Diagnostik und Therapie des hepatozellulären Karzinoms

Die Onkologie - Die Inzidenz des hepatozellulären Karzinoms (HCC) steigt seit einigen Jahren weltweit. Die Grundlage für die HCC-Entwicklung ist meist eine Leberzirrhose verschiedener...     

Diagnostik und Therapie des hepatozellulären Karzinoms

Aims

Hepatocellular carcinoma (HCC) is a frequent complication of liver cirrhosis. Worldwide HCC is one of the most common cancers with a rising incidence.

Content

Rapid recognition of HCC and the earliest possible treatment are decisive for the further course. Both treatment of the tumor and the underlying chronic liver disease, including preservation of liver function, are important for the management of patients with HCC.

Conclusion/recommendations

Standard stage-adapted treatments include liver resection, transplantation, and interventional treatment such as thermal ablation and transarterial therapy. In the advanced stage, treatment with the tyrosinekinase inhibitor sorafenib is the standard of care.     

Diagnostik und Therapie der tumorbedingten Hyperkalzämie

best practice onkologie - Hyperkalzämie findet sich im klinischen Alltag regelmäßig. Zu den häufigsten Ursachen zählen primärer Hyperparathyreoidismus und Malignome...     

Rationale Diagnostik und Therapie der Anämie

best practice onkologie - Die Weltgesundheitsorganisation (WHO) definiert Anämie als Verminderung des Hämoglobins, bei Frauen <12 g/dl und bei Männern...