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Geriatrische gastrointestinale Onkologie: Leber, Galle, Pankreas

Geriatric gastrointestinal oncology: liver, gallbladder, pancreas

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Zusammenfassung

Bereits heute liegt das mittlere Erkrankungsalter für Patienten mit Karzinomen des pankreatikohepatobiliären Systems jenseits des 70. Lebensjahrs. Ein weiterer Anstieg wird erwartet. In prospektiven klinischen Studien in allen Therapieszenarien sind geriatrische Patienten nicht adäquat repräsentiert. Das chronologische Alter per se stellt keine Kontraindikation für eine stadiengerechte Therapie dieser Karzinome dar. Vorliegende Daten belegen nicht, dass das chronologische Patientenalter der dominante Einflussfaktor auf das posttherapeutische Überleben ist. Vielmehr müssen in dieser Patientenpopulation andere Aspekte in eine Therapieentscheidung einbezogen werden. Dazu gehören nicht nur Komorbiditäten und der Allgemeinzustand sondern auch Faktoren, die auf eine posttherapeutische Rekonvaleszenz einen Einfluss haben. Optimalerweise wird hierzu ein multidimensionales geriatrisches Assessment angewendet.

Abstract

The median age of patients diagnosed with cancer of the liver or pancreaticobiliary system is beyond 70 years. This will further increase in the future. However, geriatric patients are not adequately addressed in prospective clinical trials in oncology. Chronological age per se does not constitute a contraindication against stage-adopted therapies. Published data do not substantiate that chronological age is the dominant influencing factor on posttherapeutic survival. Other factors need to be considered if a therapeutic decision in an elderly patient needs to be taken, including comorbidities, performance status, and factors impacting on posttherapeutic convalescence. A multidimensional geriatric assessment is strongly encouraged.

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Authors and Affiliations

  1. Medizinische Klinik und Poliklinik 2, Klinikum der Ludwig-Maximilians-Universität München (LMU), Marchioninistr. 15, 81388, München, Deutschland

    Christian Schulz

  2. Klinik für Innere Medizin und Gastroenterologie, Niels-Stensen-Kliniken Marienhospital Osnabrück, Bischofsstr. 1, 49074, Osnabrück, Deutschland

    Kerstin Schütte

  3. Klinik für Gastroenterologie, Hepatologie und Infektiologie, Otto-von-Guericke Universität Magdeburg, Leipziger Str. 44, 39120, Magdeburg, Deutschland

    Kerstin Schütte

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  1. Christian Schulz
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Correspondence to Christian Schulz.

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Interessenkonflikt

K. Schütte hat Referenten- oder Beraterhonorare von den Firmen Bayer Healthcare, Ipsen, Roche Pharma und Servier erhalten. C. Schulz gibt an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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Martina Müller-Schilling, Regensburg

Werner‑J. Mayet, Sande

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Schulz, C., Schütte, K. Geriatrische gastrointestinale Onkologie: Leber, Galle, Pankreas. Gastroenterologe 16, 378–386 (2021). https://doi.org/10.1007/s11377-021-00549-9

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