Staging des Lungenkarzinoms: Welche Rolle spielt die Mediastinoskopie heute?

Zusammenfassung

Für das invasive Lymphknotenstaging im Rahmen der Abklärung eines Lungenkarzinomes stehen heute zahlreiche Methoden zur Verfügung. Während bis vor wenigen Jahren die Mediastinoskopie und anteriore Mediastinotomie als der Goldstandard in jeder Situation angesehen wurde, ist inzwischen die EBUS-TBNA soweit ausgereift, dass sie in der primären Abklärung verdächtiger normal großer und vergrößerter Lymphknoten im Bereich der Stationen 2 L / R, 4 L / R und 7 als Alternative zur Mediastinoskopie eingesetzt wird und für die Mediastinoskopie der Status als Goldstandard nur noch speziellen Situationen vorbehalten ist. Dazu gehört die Überprüfung negativer EBUS-TBNA-Ergebnisse verdächtiger Lymphknoten in den o. g. Stationen und die Evaluation mediastinaler Lymphknoten nach neoadjuvanter Chemotherapie.

Abstract

Today several methods for invasive mediastinal staging of lung cancer are available. Whereas mediastinoscopy and anterior mediastinotomy had been the gold standard in every situation several years ago, today EBUS-TBNA has been developed as an alternative to mediastinoscopy concerning the status of lymph node positions 2 L / R, 4 L / R and 7. Actually mediastinoscopy is accepted as the gold standard only in special situations such as negative cytology of suspicious lymph nodes after EBUS-TBNA and mediastinal evaluation after neoadjuvant treatment.

Schlüsselwörter

Krebs - Lymphadenektomie - Mediastinoskopie - neoadjuvante Chemotherapie - Thoraxchirurgie

Key words

cancer - lymphadenectomy - mediastinoscopy - neoadjuvant chemotherapy - thoracic surgery

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