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Stellenwert der Metastasenchirurgie beim fortgeschrittenen Pankreaskarzinom

Impact of surgery of metastases in advanced pancreatic cancer

  • Leitthema
  • Published:
Der Onkologe Aims and scope

Zusammenfassung

Hintergrund

Entsprechend den aktuell geltenden Leitlinien werden resezierende Verfahren im metastasierten Stadium beim Pankreaskarzinom nicht empfohlen. In der klinischen Praxis werden Tumor- und Metastasenresektionen jedoch in individuellen Einzelfällen durchgeführt.

Ziel

Diese Übersichtsarbeit fasst die aktuell vorhandene Evidenz anhand der veröffentlichten Studienlage zusammen.

Material und Methoden

Eine systematische Literaturrecherche (PUBMED und MEDLINE) zum Thema resezierender Eingriffe im metastasierten Stadium des Pankreaskarzinoms wurde durchgeführt

Ergebnisse

Insgesamt stellt sich das Evidenzniveau als schwach dar, es sind aktuell keine prospektiven Studien zu diesem Thema verfügbar. Die vorhandenen retrospektiven Arbeiten zeigen eine technische Machbarkeit synchroner Tumor- und Metastasenresektionen mit möglicherweise onkologischen Vorteilen für spezifische Patientensubgruppen.

Schlussfolgerung

Das Evidenzniveau ist zu schwach, um grundsätzliche Therapieentscheidungen für Patienten im oligometastasierten Stadium ableiten zu können. Prospektive Studien zu dem Thema sind notwendig, um feststellen zu können, ob eine Metastasenchirurgie, eingebettet in multimodale Therapiekonzepte, sinnvoll durchzuführen ist.

Abstract

Background

According to the current guidelines surgery is not recommended in the metastasized stage of pancreatic cancer; however, in clinical practice surgery including resection of the primary tumor and metastases is performed in individual cases.

Aim

This review article summarizes the currently available evidence based on the published studies.

Material and methods

A systematic search in MEDLINE and PubMed was performed with respect to metastasized pancreatic cancer and surgical resection.

Results

The evidence level is not sufficient to answer the question as to whether patients in an oligometastasized stage should be operated on or not. The available retrospective studies show a technical feasibility of synchronous resection of the primary tumor and metastases with a possibly beneficial oncological outcome for specific patient groups.

Conclusion

Based on the currently available evidence, a general treatment decision for patients in an oligometastatic stage cannot be derived. Therefore, prospective clinical trials are necessary to answer the question of which patients could benefit from a combined resection of primary tumor and metastases embedded in a multimodal treatment concept.

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Authors and Affiliations

  1. Klinik für Allgemein‑, Viszeral und Tumorchirurgie, Uniklinik Köln, Kerpener Straße 62, 50937, Köln, Deutschland

    Christiane Bruns & Florian Gebauer

  2. Klinik und Poliklinik für Chirurgie, Klinikum rechts der Isar, Medizinische Fakultät, Technische Universität München, München, Deutschland

    Florian Scheufele & Helmut Friess

Authors
  1. Christiane Bruns
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  2. Florian Gebauer
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  3. Florian Scheufele
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  4. Helmut Friess
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Corresponding author

Correspondence to Christiane Bruns.

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Interessenkonflikt

C. Bruns, F. Gebauer, F. Scheufele und H. Friess geben an, dass in Hinblick auf diese Arbeit kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren, nur eine Zusammenstellung der vorhandenen Literatur.

Additional information

C. Bruns und F. Gebauer: gleichwertige Erstautorenschaft

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Bruns, C., Gebauer, F., Scheufele, F. et al. Stellenwert der Metastasenchirurgie beim fortgeschrittenen Pankreaskarzinom. Onkologe 25, 690–695 (2019). https://doi.org/10.1007/s00761-019-0547-8

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  • DOI: https://doi.org/10.1007/s00761-019-0547-8

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