{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T23:43:08Z","timestamp":1786146188647,"version":"build-2736575974"},"reference-count":10,"publisher":"Georg Thieme Verlag KG","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Zentralbl Chir"],"abstract":"<jats:title>Zusammenfassung<\/jats:title>\n                  <jats:p>Durch den Einsatz moderner systemischer Therapien, insbesondere\n\t\t\t\tImmuncheckpoint-Inhibitoren und im Falle von Malignomen mit Treibermutationen\n\t\t\t\tzielgerichteter Substanzen, hat sich die Prognose von Patienten auch mit\n\t\t\t\tfortgeschrittenem nicht kleinzelligem Lungenkarzinom (NSCLC) deutlich verbessert.\n\t\t\t\tMit verl\u00e4ngerten \u00dcberlebenszeiten und intensiverer Therapieexposition steigt jedoch\n\t\t\t\tauch das Risiko schwerer tumor- oder therapieassoziierter Komplikationen. Eine\n\t\t\t\tinfekti\u00f6se Einschmelzung des Prim\u00e4rtumors kann eine akut lebensbedrohliche Situation\n\t\t\t\tdarstellen und verhindert h\u00e4ufig die Fortf\u00fchrung der onkologischen Therapie. Der\n\t\t\t\tStellenwert sogenannter thoraxchirurgischer \u201eRescue-Eingriffe\u201c zur Beherrschung\n\t\t\t\tdieser Komplikationen ist bislang unklar und wird kontrovers diskutiert.<\/jats:p>\n                  <jats:p>In dieser retrospektiven Fallserie werden 10 Patienten beschrieben, die in einem\n\t\t\t\tZeitraum von 3 Jahren aufgrund einer systemtherapieinduzierten, progredienten\n\t\t\t\tinfekti\u00f6sen Tumoreinschmelzung einer Rescue-Operation unterzogen wurden. Untersucht\n\t\t\t\twurden Indikationsstellung, Art und Zeitpunkt der vorausgegangenen Systemtherapie,\n\t\t\t\tOperationsausma\u00df, perioperative Komplikationen sowie postoperatives\n\t\t\t\t\u00dcberleben.<\/jats:p>\n                  <jats:p>Die Kohorte umfasst 2 Frauen und 8 M\u00e4nner mit einem mittleren Alter von 67 Jahren\n\t\t\t\tund \u00fcberwiegend fortgeschrittenen Tumorstadien (IIB\u2013IVB). Die Rescue-Operation\n\t\t\t\terfolgte im Mittel 4,2 Monate nach Beginn der Systemtherapie. Indikationen waren in\n\t\t\t\tallen F\u00e4llen eine progrediente infekti\u00f6se Einschmelzung des Prim\u00e4rtumors mit\n\t\t\t\tseptischer Konstellation, teils begleitet von H\u00e4moptysen oder Pleuraempyem, nach\n\t\t\t\tAussch\u00f6pfung aller konservativen Optionen. Operativ wurden \u00fcberwiegend offene\n\t\t\t\tThorakotomien durchgef\u00fchrt (7 von 10); das Resektionsspektrum reichte von\n\t\t\t\tLobektomien \u00fcber erweiterte Lobektomien bis zur Pneumektomie. In 9 von 10 F\u00e4llen\n\t\t\t\twurde eine R0-Resektion erzielt. Bei 8 Patienten konnte nach Rekonvaleszenz eine\n\t\t\t\ttumorspezifische Therapie aufgenommen werden. Die mediane postoperative\n\t\t\t\t\u00dcberlebenszeit lag bei 19 Monaten.<\/jats:p>\n                  <jats:p>Rescue-Resektionen bei infekti\u00f6ser Tumoreinschmelzung unter Systemtherapie sind\n\t\t\t\ttechnisch anspruchsvolle Eingriffe bei kritisch kranken Patienten und mit einer\n\t\t\t\terh\u00f6hten Komplikationsrate verbunden. In ausgew\u00e4hlten F\u00e4llen kann die operative\n\t\t\t\tKontrolle des infekti\u00f6sen Fokus jedoch zur Stabilisierung des klinischen Zustandes\n\t\t\t\tbeitragen und eine erneute tumorspezifische Therapie erm\u00f6glichen. Sie sollten daher\n\t\t\t\tals individualisierte Ultima-Ratio-Entscheidung vorzugsweise in erfahrenen\n\t\t\t\tthoraxchirurgischen Zentren erwogen werden.<\/jats:p>","DOI":"10.1055\/a-2919-5890","type":"journal-article","created":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T22:59:14Z","timestamp":1786143554000},"source":"Crossref","is-referenced-by-count":0,"title":["Thoraxchirurgische Rescue-Resektionen bei septisch zerfallenden Lungenkarzinomen unter Systemtherapie: eine Fallserie"],"prefix":"10.1055","author":[{"given":"Dominik","family":"Lobinger","sequence":"additional","affiliation":[{"name":"M\u00fcnchen Klinik Bogenhausen, Deutschland","place":["M\u00fcnchen"],"department":["Klinik f\u00fcr Thoraxchirurgie"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Hiebinger","sequence":"additional","affiliation":[{"name":"M\u00fcnchen Klinik Bogenhausen, Deutschland","place":["M\u00fcnchen"],"department":["Klinik f\u00fcr 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Deutschland","place":["M\u00fcnchen"],"department":["Klinik f\u00fcr Thoraxchirurgie"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alicia","family":"Reiche","sequence":"additional","affiliation":[{"name":"M\u00fcnchen Klinik Bogenhausen, Deutschland","place":["M\u00fcnchen"],"department":["Klinik f\u00fcr Thoraxchirurgie"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johannes","family":"Bodner","sequence":"additional","affiliation":[{"name":"M\u00fcnchen Klinik Bogenhausen, Deutschland","place":["M\u00fcnchen"],"department":["Klinik f\u00fcr Thoraxchirurgie"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,8,7]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"186","DOI":"10.1038\/s41392-025-02243-6","article-title":"Advances in molecular pathology and therapy of non-small cell lung\n\t\t\t\t\tcancer","volume":"10","author":"Q 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