Sarkome beim alten und geriatrischen Patienten

Chapter
Part of the Springer Reference Medizin book series (SRM)

Zusammenfassung

Weichgewebesarkome beim alten und geriatrischen Patienten machen mehr als ein Drittel der Gesamtpopulation dieser seltenen Tumorentität aus. Lokalisation und Größe der Tumoren sowie die verschiedenen biologischen Eigenschaften der Sarkom-Subtypen müssen in den verschiedenen Altersklassen beachtet werden. Häufig werden ältere Patienten nur einer eingeschränkten Behandlung unterzogen. Es gibt jedoch keinen Grund, beispielsweise auf eine indizierte adjuvante Strahlentherapie zu verzichten. Ein höheres Lebensalter darf auch nicht per se eine Kontraindikation für einen multimodalen Therapieansatz unter Einschluss z. B. einer Chemotherapie sein. Allerdings müssen besondere Aspekte hinsichtlich Sicherheit der Behandlung, Komorbiditäten, Toxizität und Lebensqualität beachtet werden. Für Patienten mit Primärtumoren, die einer Resektion nicht zugänglich sind, kann eine definitive Strahlentherapie eine morbiditätsarme Behandlungsalternative darstellen. Der Einsatz eines geriatrischen Assessments und insbesondere der Einsatz von prädiktiven Instrumenten zur Abschätzung der zu erwartenden Chemotherapie-assoziierten Toxizität sind in diesem Umfeld hilfreich. Osteosarkome beim alten und geriatrischen Patienten stellen eine Rarität dar. Die primäre adäquate chirurgische Versorgung der Patienten scheint gerade in dieser Patientenpopulation prognostisch von zentraler Bedeutung zu sein, während die Addition einer Chemotherapie das Überleben der Patienten nicht signifikant verbessert.

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Copyright information

© Springer-Verlag GmbH Deutschland, ein Teil von Springer Nature 2018

Authors and Affiliations

  1. 1.Sarkom Zentrum, Interdisziplinäres Tumorzentrum Mannheim (ITM)Universitätsmedizin MannheimMannheimDeutschland
  2. 2.Chirurgische UniversitätsklinikUniversitätsmedizin MannheimMannheimDeutschland
  3. 3.Chirurgische Onkologie und ThoraxchirurgieUniversitätsmedizin MannheimMannheimDeutschland

Section editors and affiliations

  • Nicolai Härtel
    • 1
  1. 1.Interdisziplinäres TumorzentrumUniversitätsmedizin MannheimMannheimDeutschland

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