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Viszeralchirurgie 2007; 42(2): 94-101
DOI: 10.1055/s-2007-960662
Originalarbeit

© Georg Thieme Verlag Stuttgart · New York

Interdisziplinäres Management resektabler kolorektaler Lebermetastasen

Interdisciplinary Management of Resectable Colorectal Liver MetastasesC. Gog1 , W. O. Bechstein1
  • 1Universitätsklinikum Frankfurt am Main, Klinik für Allgemein- und Gefäßchirurgie
Further Information

Publication History

Publication Date:
22 May 2007 (online)

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Zusammenfassung

Lebermetastasen sind die häufigste Rezidivlokalisation nach Primäroperation eines kolorektalen Karzinoms. Ist die Leber einziger Metastasierungsort und sind die Herde lokal operabel, gilt die Leberresektion heute als Standardverfahren. Sie weist eine geringe perioperative Mortalität auf und ermöglicht teilweise lange Überlebenszeiten. Auch wiederholte Resektionen von Leberrezidiven sind möglich und erfolgversprechend. Der Nutzen einer adjuvanten Chemotherapie nach potenziell kurativer Leberresektion ist derzeit noch nicht gesichert, Patienten sollten nur im Rahmen klinischer Studien behandelt werden. Gleiches gilt für die neoadjuvante Chemotherapie. Lokal ablative Verfahren können die Resektion ersetzen oder ergänzen, doch sind derzeit noch keine evidenzbasierten Empfehlungen möglich. OncoSurge™ ist ein neu entwickeltes, auf Studiendaten und Expertenwissen basierendes Entscheidungsmodell, das die Beurteilung der individuellen Eignung von Patienten zur Lebermetastasenresektion vereinfachen soll.

Abstract

The liver is the most common site of distant relapse after primary surgical therapy for colorectal cancer. Liver resection is the standard treatment for isolated and locally resectable liver metastases, with low perioperative mortality and significant long-term survival rates. Repeat liver resections for recurrent liver metastasis are feasible and have resulted in encouraging survival. The role of adjuvant chemotherapy after potentially curative resection of liver metastases is still uncertain, and patients should be included in clinical trials. This also applies to neoadjuvant chemotherapy. Local ablative techniques may be used instead of or in addition to surgical resection, but no evidence-based recommendations can be given at the time. OncoSurge™, a newly developed decision model based on available study results as well as expert consensus may allow for better patient selection for liver resection.

Schlüsselwörter

kolorektales Karzinom - Lebermetastasen - Leberresektion - adjuvante Chemotherapie - lokale Ablation

Key words

colorectal cancer - liver metastasis - liver resection - adjuvant chemotherapy - local ablation

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Dr. med. C. Gog

Theodor-Stern-Kai 7

60590 Frankfurt am Main

Phone: 0 69/63 01 41 67

Email: Christiane.Gog@kgu.de

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