Chirurgische Therapie des hepatozellulären Karzinoms
Tóm tắt
Die chirurgische Therapie des hepatozellulären Karzinoms (HCC) mit vollständiger Entfernung des Tumors oder die Lebertransplantation kann eine langfristige Heilung ermöglichen. Beide Verfahren sind primär oder im Rahmen neoadjuvanter Konzepte durchführbar. In bestimmten Fällen kann ein lokoregionäres Verfahren mit kurativer Zielsetzung angewandt werden. Die Zuordnung des Patienten zu einer primär chirurgisch kurativen, neoadjuvanten oder palliativen Vorgehensweise ist, neben der hepatischen und extrahepatischen Tumorausdehnung, von der vorbestehenden chronischen Leberschädigung abhängig. Die individuelle Grenze der Resektabilität ergibt sich aus der notwendigen Radikalität und dem für eine suffiziente postoperative Leberfunktion erforderlichen Parenchymrest. Aus diesem Grund ist das Ausmaß der zirrhotischen Leberschädigung für die Auswahl und die Sequenz der Therapiemaßnahmen entscheidend.
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