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Oligometastasierung beim kolorektalen Karzinom – moderne Therapiekonzepte

  • M. Binnebösel
  • A. Lambertz
  • K. Dejong
  • U. P. Neumann
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Zusammenfassung

Hintergrund

Die Prognose des kolorektalen Karzinoms (KRK) im UICC-Stadium IV hat sich durch die Verbesserungen der interdisziplinären Therapie in den letzten Jahrzehnten deutlich verbessert.

Material und Methoden

Behandlungsstrategien des oligometastasierten kolorektalen Karzinoms entwickeln sich zunehmend hin zu einer individualisierten Therapie. Es soll eine Übersicht der aktuellen Literatur zu modernen Therapiekonzepten in der Oligometastasierung beim KRK im Stadium IV gegeben werden.

Ergebnisse

Oberstes Mandat bei resektablen kolorektalen Lebermetastasen hat weiterhin die Chirurgie, neoadjuvante und adjuvante Therapiekonzepte sind ohne onkologischen Vorteil. Bei marginal oder nichtresektablen Stadien steht eine systemische Therapie, abhängig von der prognostischen Einstufung der Patienten im Vordergrund. Auch in der kurativen Situation sind lokale Therapieverfahren sinnvoll additiv einsetzbar. Ein interessanter Therapieansatz bei isoliert hepatisch metastasierten, nichtresektablen KRK ist die Lebertransplantation.

Schlussfolgerung

Unabhängig von neuen Entwicklungen in der Behandlung des metastasierten kolorektalen Karzinoms bleibt die Resektion kolorektaler Lebermetastasen der Goldstandard der onkologischen Therapie wann immer möglich.

Schlüsselwörter

Kolorektale Lebermetastasen Behandlungsstrategien Individualisierte Therapie  Extrahepatischer Tumorbefall Leberchirurgie 

Oligometastasized colorectal cancer—modern treatment strategies

Abstract

Background

The prognosis of colorectal cancer in UICC stage IV has been improved in the last decades by improvements in interdisciplinary treatment.

Material and methods

Treatment strategies for oligometastasized colorectal cancer are developing more and more into an individualized treatment. An overview of the current literature of modern treatment concepts in oligometastasized colorectal cancer UICC stage IV is given.

Results

Surgery still has the supreme mandate in resectable colorectal liver metastases, as neoadjuvant and adjuvant treatment strategies to not provide any benefits for these patients. In marginal or non-resectable stages systemic treatment is superior in these patients depending on the prognostic parameters. Also in curative settings local treatment options should be considered as a reasonable additive tool. An interesting treatment approach for isolated liver metastases and non-resectable colorectal cancer is liver transplantation.

Conclusion

Irrespective of new developments in treatment strategies for metastasized colorectal cancer, resection of colorectal liver metastases remains the gold standard whenever possible.

Keywords

Colorectal liver metastases Treatment strategies Individualized treatment Extrahepatic tumor infestation Liver surgery 

Notes

Einhaltung ethischer Richtlinien

Interessenkonflikt

M. Binnebösel, A. Lambertz, K. Dejong und U.P. Neumann geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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Copyright information

© Springer Medizin Verlag GmbH, ein Teil von Springer Nature 2018

Authors and Affiliations

  • M. Binnebösel
    • 1
    • 2
    • 3
  • A. Lambertz
    • 1
  • K. Dejong
    • 1
    • 2
  • U. P. Neumann
    • 1
    • 2
  1. 1.Klinik für Allgemein‑, Viszeral- und TransplantationschirurgieUniklinik der RWTH AachenAachenDeutschland
  2. 2.Department of SurgeryUniversity Medical Center MaastrichtMaastrichtNiederlande
  3. 3.Klinik für Allgemein- und ViszeralchirurgieKlinikum BielefeldBielefeldDeutschland

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