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Prinzipien der Tumorklassifikation

  • C. Wittekind

Zusammenfassung

Das Ziel einer Tumorklassifikation ist es, die Individualität eines bestimmten Tumors möglichst genau zu beschreiben. Dazu werden Tumoren in speziell definierte Gruppen und Subgruppen eingeteilt. Solche Einteilungen, die bei bestimmten Organtumoren unterschiedlich detailliert sein können, sind die Basis therapeutischer Entscheidungen und dienen somit einer klassifikationsgerechten Therapie. Durch die Anwendung verschiedener Klassifikationen ergeben sich zahlreiche Subgruppen. Tumoren, die eine speziell definierte Gruppe bilden, sind allerdings nicht völlig identisch, sondern ähneln sich untereinander mehr als Tumoren, die einer anderen Gruppe zugehören. Solche Klassifikationssysteme sind in der Regel gut zu handhaben, die Anwender (u. a. Klinker und Pathologen) müssen sich aber über die Grenzen im Klaren sein. Diese Grenzen liegen u. a. in der Schwierigkeit, einzelne Tumorentitäten richtig zuzuordnen. Dies gilt für die histologischen Klassifikationen, aber auch für die Bestimmung des Malignitätsgrades („grading“). Als Folge kann eine schlechte Reproduzierbarkeit resultieren, die der Feind jeder Klassifikation ist. Die Klassifikationen sind keine theoretische Angelegenheit des Pathologen, sondern sie haben ganz wesentlich auch klinische Aufgaben zu erfüllen. Dazu gehören:
  • international vergleichbare Grundlagen für die Planung und Durchführung von Therapien zu schaffen, besonders mit dem Ziel einer histologie- und stadiengerechten Therapie,

  • wichtige Daten für die Schätzung der individuellen Pognose zu liefern,

  • Voraussetzungen für eine aussagekräftige Beurtei-lung von Behandlungsergebnisssen zu schaffen,

  • den Vergleich diagnostischer und therapeutischer Leistungen unterschiedlicher Behandlungszentren zu ermöglichen.

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© Springer-Verlag Berlin Heidelberg 2001

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  • C. Wittekind

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