Zusammenfassung
Die chirurgische Resektion stellt nach wie vor den einzigen kurativen Therapieansatz des hepatisch metastasierten kolorektalen Karzinoms dar und führt zu einer signifikanten Lebensverlängerung der Patienten. Sowohl der Anteil an Patienten, die einer kurativen Resektion zugeführt werden können, als auch das Überleben nach Leberresektion kann durch moderne multimodale Therapiekonzepte erhöht werden. Dazu haben Fortschritte der chemotherapeutischen Vor- und Nachbehandlung, aber auch der Chirurgie, der interventionellen Radiologie und nicht zuletzt der individualisierten Chemotherapie beigetragen. Durch die Vielzahl der Neuerungen lässt sich bisher noch nicht für alle Untergruppen der insgesamt inhomogenen Gruppe von Patienten mit hepatisch metastasiertem kolorektalen Karzinom ein einheitlicher Behandlungsalgorithmus aufstellen. In der folgenden Übersichtsarbeit werden der aktuelle Stand der multimodalen Therapie und die momentan noch offenen Fragen wiedergegeben.
Abstract
Surgical resection is the only chance of cure for patients with colorectal liver metastases und significantly improves patient survival. The percentage of patients who can undergo curative resection as well as the survival after liver resection can be increased by using modern multimodal treatment algorithms. This has been achieved by not only innovations in pre- and postoperative chemotherapy but also by new surgical and interventional techniques and last but not least by individualisation of chemotherapeutic regimens. Due to the high number of new treatment modalities, a generally accepted treatment algorithm cannot be provided so far for all subgroups of the inhomogeneous group of patients with colorectal liver metastases. In the present review the current status of multimodal therapy is outlined and the pending questions mentioned.
Schlüsselwörter
Lebermetastasen - Leberresektion - neoadjuvante Chemotherapie - multimodale Therapie
Key words
liver metastasis - liver resection - neoadjuvant chemotherapy - multimodal treatment
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Dr. D. Seehofer
Charité – Universitätsmedizin Berlin · Campus Virchow Klinikum · Klinik für Allgemein-, Viszeral- und Transplantationschirurgie
13353 Berlin
Deutschland
Telefon: 0 30 / 4 50 55 20 01
Fax: 0 30 / 4 50 55 29 00
eMail: daniel.seehofer@charite.de
