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Maligne Lebertumoren

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Evidenzbasierte Viszeralchirurgie maligner Erkrankungen

Part of the book series: Evidenzbasierte Chirurgie ((EC))

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Zusammenfassung

Das hepatozelluläre Karzinom (HCC) ist der häufigste maligne Lebertumor, gefolgt vom intrahepatischen Cholangiokarzinom (IHCC). Für beide Tumorentitäten stützt sich die Diagnostik in den Leitlinien auf KM-verstärkte Schnittbildgebung. Die Therapieempfehlungen zum HCC orientieren sich in den europäischen und amerikanischen Leitlinien am BCLC-Schema, während dies in Asien kritischer gesehen wird. Die Lebertransplantation ist für Tumoren innerhalb der Mailand-Kriterien die effektivste Behandlung, während die Resektion nach derzeitigem Wissenstand die zweitbeste Option darstellt. Die RFA ist den vorhandenen Daten zufolge der Resektion hinsichtlich rezidivfreien Überlebens unterlegen. Beim IHCC besteht in der Resektion mit ausreichendem Sicherheitsabstand die einzig kurative Option. Die Rolle der regionalen Lymphadenektomie wird kontrovers gesehen, jedoch in den meisten Leitlinien empfohlen. Insgesamt ist die Datenlage beim HCC mangelhaft und beim IHCC bestenfalls als schlecht anzusehen.

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  1. Universitätsklinikum Freiburg, Klinik für Allgemein- und Viszeralchirurgie, Freiburg, Deutschland

    Prof. Dr. med. S. A. Lang & Prof. Dr. med. S. Fichtner-Feigl

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  1. Universitätsklinikum Würzburg, Würzburg, Deutschland

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  3. ehem. Wissenschaftlich Medizinischer Direktor Kreiskliniken Altötting-Burghausen, Burghausen, Deutschland

    Reinhart T. Grundmann

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Lang, S.A., Fichtner-Feigl, S. (2018). Maligne Lebertumoren. In: Germer, CT., Keck, T., Grundmann, R.T. (eds) Evidenzbasierte Viszeralchirurgie maligner Erkrankungen. Evidenzbasierte Chirurgie. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-56533-9_5

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  • Online ISBN: 978-3-662-56533-9

  • eBook Packages: Medicine (German Language)

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