Stellenwert des Proliferationsreizes auf die okkulte Mikrometastasierung sowie Rezidivhäufigkeit und Prognose nach Resektion von Lebermalignomen

Zusammenfassung

Patienten mit malignen Lebertumoren werden regelmäßig einer partiellen Hepatektomie im Rahmen von kurativen Therapiekonzepten unterzogen. Limitierend für die Langzeitprognose dieser Patienten ist das häufige Auftreten von Tumorrezidiven. Aktuelle klinische und experimentelle Daten legen nahe, dass zelluläre und molekulare Veränderungen während der nachfolgenden Regeneration des verbleibenden Leberparenchyms einen Proliferationsreiz auf okkulte Mikrometastasen und zirkulierende Tumorzellen ausüben und dadurch die Entwicklung einer Rezidiverkrankung begünstigen. Wachstumsfaktoren und Zytokine, die eine essenzielle Rolle für die Leberregeneration spielen, wurden ebenfalls mit Tumorwachstum und Metastasierung in Verbindung gebracht. Die genauen Mechanismen der Interaktion zwischen regenerierendem Lebergewebe und Tumorzellproliferation bleiben jedoch weiterhin ungeklärt und sind mögliche Angriffspunkte für zukünftige adjuvante Therapien mit dem Ziel, das rezidivfreie Überleben von Patienten nach onkologischer Leberresektion zu verbessern.

Abstract

Liver resection is currently considered to be essential part of the curative treatment of primary and secondary liver malignancies. However, long-term survival in these patients is limited by the high incidence of tumor recurrence. Recent clinical and experimental studies have indicated that cellular and molecular mechanisms associated with liver regeneration after partial hepatectomy may have a proliferative effect on occult micrometastases and circulating tumor cells and are thus responsible for recurrent disease. Growth factors and cytokines involved in liver regeneration have also been shown to influence tumour growth and metastasis. However, the underlying mechanisms explaining the interactions between regenerating liver tissue and tumour cell proliferation remain unclear. The development of modern agents specifically targeting these processes may improve disease-free and overall survival rates after oncological hepatectomy.

Schlüsselwörter

Leberregeneration - Lebertumor - Leberresektion

Key words

liver resection - liver tumor - liver regeneration

• Literatur

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