Zusammenfassung
Die altersstandardisierte Inzidenzrate der Gallenblasen- und Gallengangskarzinome pro 100.000 Einwohner in Deutschland 2012 ist 5,5/100.000 für Männer und 6,8/100.000 für Frauen. Das mittlere Erkrankungsalter liegt bei 72 Jahren für Männer und 76 Jahren für Frauen, laut Abfrage der Krebsregisterdaten vom RKI 2016. Die cholangiozellulären Karzinome sind damit eine seltene Entität. Eine Heilung ist nur durch die R0-Operation möglich. Bei der initialen Präsentation können jedoch 2/3 der Patienten nicht mehr kurativ operiert werden. Hinzu kommt bei dem extrahepatischen cholangiozellulären Karzinom eine oft komplexe interventionelle Therapie als Teil der palliativen Therapie. Damit bestehen bei dem Gallengangskarzinom zwei Herausforderungen: Die optimale chirurgische Versorgung einer seltenen Krankheit, ohne die keine Kuration erreicht werden kann, und das Vorhalten eines breiten interventionellen Armamentarium mit der entsprechenden Expertise, es strategisch einzusetzen.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Literatur
Finkelmeier F, Tal A, Ajouaou M, Filmann N, Zeuzem S, Waidmann O et al (2015) ERCP in elderly patients: increased risk of sedation adverse events but low frequency of post-ERCP pancreatitis. Gastrointest Endosc 82(6):1051–1059
Fiteni F, Nguyen T, Vernerey D, Paillard M-J, Kim S, Demarchi M et al (2014) Cisplatin/gemcitabine or oxaliplatin/gemcitabine in the treatment of advanced biliary tract cancer: a systematic review. Cancer Med 3(6):1502–1511
Fornaro L, Vivaldi C, Cereda S, Leone F, Aprile G, Lonardi S et al (2015) Second-line chemotherapy in advanced biliary cancer progressed to first-line platinum-gemcitabine combination: a multicenter survey and pooled analysis with published data. J Exp Clin Cancer Res 34:156. https://doi.org/10.1186/s13046-015-0267-x.
Hollebecque A, Bouché O, Romano O, Scaglia E, Cattan S, Zerbib P et al (2010) Experience of gemcitabine plus oxaliplatin chemotherapy in patients with advanced biliary tract carcinoma. Chemotherapy 56(3):234–238
Horgan AM, Amir E, Walter T, Knox JJ (2012) Adjuvant therapy in the treatment of biliary tract cancer: a systematic review and meta-analysis. J Clin Oncol 30(16):1934–1940
Inamdar S, Slattery E, Bhalla R, Sejpal DV, Trindade AJ (2016) Comparison of adverse events for endoscopic vs percutaneous biliary drainage in the treatment of malignant biliary tract obstruction in an inpatient national cohort. JAMA Oncol 2(1):112–117
Lu Y, Liu L, Wu J-c, Bie L-k, Gong B (2015) Efficacy and safety of photodynamic therapy for unresectable cholangiocarcinoma: a meta-analysis. Clin Res Hepatol Gastroenterol 39(6):718–724
Matull W-R, Dhar DK, Ayaru L, Sandanayake NS, Chapman MH, Dias A et al (2010) R0 but not R1/R2 resection is associated with better survival than palliative photodynamic therapy in biliary tract cancer. Liver Int 31(1):99–107
Murakami Y, Uemura K, Sudo T, Hashimoto Y, Nakashima A, Kondo N et al (2010) Prognostic factors after surgical resection for intrahepatic, Hilar, and distal cholangiocarcinoma. Ann Surg Oncol 18(3):651–658
Ortner MA, Dorta G (2006) Technology Insight: photodynamic therapy for cholangiocarcinoma. Nat Clin Pract Gastroenterol Hepatol 3(8):459–467
Ortner MEJ, Caca K, Berr F, Liebetruth J, Mansmann U, Huster D et al (2003) Successful photodynamic therapy for nonresectable cholangiocarcinoma: a randomized prospective study. Gastroenterology 125(5):1355–1363
Park DH, Lee SS, Park SE, Lee JL, Choi JH, Choi HJ et al (2014) Randomised phase II trial of photodynamic therapy plus oral fluoropyrimidine, S-1, versus photodynamic therapy alone for unresectable hilar cholangiocarcinoma. Eur J Cancer 50(7):1259–1268
Robert Koch-Institut (2017) Zentrum für Krebsregisterdaten (ZfKD). http://www.krebsdaten.de/Krebs/DE/Datenbankabfrage/datenbankabfrage_stufe1_node.html. Zugegriffen am 15.07.2017
Takada T, Amano H, Yasuda H, Nimura Y, Matsushiro T, Kato H, Nagakawa T, Nakayama T, Study Group of Surgical Adjuvant Therapy for Carcinomas of the Pancreas and Biliary Tract (2002) Is postoperative adjuvant chemotherapy useful for gallbladder carcinoma? A phase III multicenter prospective randomized controlled trial in patients with resected pancreaticobiliary carcinoma. Cancer 95(8):1685–1695
Valle J, Wasan H, Palmer DH, Cunningham D, Anthoney A, Maraveyas A et al (2010) Cisplatin plus gemcitabine versus gemcitabine for biliary tract cancer. N Engl J Med 362(14):1273–1281
Vitale A, Spolverato G, Bagante F, Gani F, Popescu I, Marques HP et al (2016) A multi-institutional analysis of elderly patients undergoing a liver resection for intrahepatic cholangiocarcinoma. J Surg Oncol 113(4):420–426
Walter D, van Boeckel PGA, Groenen MJ, Weusten BLAM, Witteman BJ, Tan G et al (2015) Cost efficacy of metal stents for palliation of extrahepatic bile duct obstruction in a randomized controlled trial. Gastroenterology 149(1):130–138
Wellner UF, Shen Y, Keck T, Jin W, Xu Z (2017) The survival outcome and prognostic factors for distal cholangiocarcinoma following surgical resection: a meta-analysis for the 5-year survival. Surg Today. https://doi.org/10.1007/s00595-016-1362-0
Wentrup R, Winkelmann N, Mitroshkin A, Prager M, Voderholzer W, Schachschal G et al (2016) Photodynamic therapy plus chemotherapy compared with photodynamic therapy alone in Hilar nonresectable cholangiocarcinoma. Gut Liver 10(3):470–475
Witzigmann H, Berr F, Ringel U, Caca K, Uhlmann D, Schoppmeyer K et al (2006) Surgical and palliative management and outcome in 184 patients with Hilar cholangiocarcinoma. Ann Surg 244(2):230–239
Zhao X-q, Dong J-h, Jiang K, Huang X-q, Zhang W-z (2014) Comparison of percutaneous transhepatic biliary drainage and endoscopic biliary drainage in the management of malignant biliary tract obstruction: a meta-analysis. Digest Endosc 27(1):137–145
Zoepf T, Jakobs R, Arnold JC, Apel D, Riemann JF (2005) Palliation of nonresectable bile duct cancer: improved survival after photodynamic therapy. Am J Gastroenterol 100(11):2426–2430
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Section Editor information
Rights and permissions
Copyright information
© 2018 Springer-Verlag GmbH Deutschland, ein Teil von Springer Nature
About this chapter
Cite this chapter
Belle, S. (2018). Cholangiozelluläres Karzinom beim alten und geriatrischen Patienten. In: Ebert, M., Härtel, N., Wedding, U. (eds) Geriatrische Onkologie. Springer Reference Medizin. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-48727-3_28
Download citation
DOI: https://doi.org/10.1007/978-3-662-48727-3_28
Published:
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-662-48726-6
Online ISBN: 978-3-662-48727-3
eBook Packages: Medicine (German Language)