{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,8,10]],"date-time":"2024-08-10T18:40:04Z","timestamp":1723315204858},"reference-count":49,"publisher":"Georg Thieme Verlag KG","issue":"01","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Zentralbl Chir"],"published-print":{"date-parts":[[2021,2]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title><jats:p>Die Therapie lokal fortgeschrittener Tumoren des Thymus bedarf einer differenzierten Diagnostik und multimodalen Vorgehensweise, bestehend aus Operation, Radio- und\/oder Chemotherapie. Im Hinblick auf das rezidivfreie \u00dcberleben und das Langzeit\u00fcberleben stellt auch in diesem Stadium die radikale und vollst\u00e4ndige Resektion des Tumors den wichtigsten prognostischen Faktor dar. Das Masaoka-Koga-Stadium III beschreibt das lokal invasive Wachstum von malignen Thymustumoren in die mediastinalen Nachbarstrukturen. Abh\u00e4ngig vom Ausma\u00df der Tumorinfiltration kann die operative Resektion prim\u00e4r oder nach einer Induktionstherapie durchgef\u00fchrt werden. In vielen F\u00e4llen m\u00fcssen diese Tumoren jedoch auch als nicht resektabel eingestuft werden, sodass nur eine palliative Radio-\/Chemotherapie als Therapieoption bleibt. Vor wenigen Jahren wurde erstmalig eine neue TNM-Klassifikation f\u00fcr maligne Thymustumoren eingef\u00fchrt, die in vielen Teilen der klassischen Masaoka-Koga-Klassifikation zwar \u00e4hnelt, jedoch auch einige therapierelevante \u00c4nderungen beinhaltet. So wird hier zwischen den Stadien IIIA und IIIB unterschieden, mit dem Ziel, bei lokal fortgeschrittenen Thymustumoren die Resektabilit\u00e4t differenzierter einsch\u00e4tzen und folglich auch das gesamte Therapiekonzept entsprechend besser planen zu k\u00f6nnen. Neben Thymus, Thymom, perithymischem Fettgewebe, mediastinaler Pleura (Stadium I) oder Perikard (Stadium II) sollten bei Tumoren des Stadiums III alle infiltrierten Strukturen nach M\u00f6glichkeit \u201een bloc\u201c entfernt werden. W\u00e4hrend bspw. die Lunge, brachiozephale Gef\u00e4\u00dfe oder extraperikardiale Pulmonalgef\u00e4\u00dfe noch reseziert und ggf. rekonstruiert werden k\u00f6nnen, limitiert die Infiltration der Aorta oder intraperikardialer Pulmonalgef\u00e4\u00dfe h\u00e4ufig eine makroskopisch vollst\u00e4ndige Resektion.<\/jats:p>","DOI":"10.1055\/a-1192-6961","type":"journal-article","created":{"date-parts":[[2020,7,23]],"date-time":"2020-07-23T22:42:45Z","timestamp":1595544165000},"page":"119-125","source":"Crossref","is-referenced-by-count":2,"title":["Erweiterte Resektionsverfahren bei lokal fortgeschrittenen Tumoren des Thymus im Stadium III"],"prefix":"10.1055","volume":"146","author":[{"given":"Till","family":"Markowiak","sequence":"additional","affiliation":[{"name":"Abteilung f\u00fcr Thoraxchirurgie, Universit\u00e4tsklinikum Regensburg, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hans-Stefan","family":"Hofmann","sequence":"additional","affiliation":[{"name":"Abteilung f\u00fcr Thoraxchirurgie, Universit\u00e4tsklinikum Regensburg, Deutschland"},{"name":"Klinik f\u00fcr Thoraxchirurgie, Krankenhaus Barmherzige Br\u00fcder Regensburg, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Ried","sequence":"additional","affiliation":[{"name":"Abteilung f\u00fcr Thoraxchirurgie, Universit\u00e4tsklinikum Regensburg, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2020,7,23]]},"reference":[{"issue":"S 07","key":"ref1","doi-asserted-by":"crossref","first-page":"vii309","DOI":"10.1093\/annonc\/mdn471","article-title":"Thymic malignancies","volume":"19","author":"E F Smit","year":"2008","journal-title":"Ann 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