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Therapieprinzipien beim Lokalrezidiv des Rektumkarzinoms

Treatment principles for locally recurrent cancer

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Zusammenfassung

Beim isolierten Lokalrezidiv im kleinen Becken besteht zu ca. 30% die Möglichkeit der R0-Resektion. Da erwartungsgemäß bei Rezidiveingriffen im kleinen Becken die Komplikationsrate erhöht ist, sollte als erstes eine präzise Diagnostik erfolgen, die die Lokalisation des Rezidivtumors und das Ausmaß der Resektion widerspiegelt. Bei Ausschluss von Fernmetastasen sollte — wenn möglich — eine präoperative Radiochemotherapie vor Rezidivoperation erfolgen. Ist ein kuratives Konzept nicht durchführbar, verbleibt die Strahlentherapie als palliative Maßnahme. Diese Arbeit stellt verschiedene Behandlungsmöglichkeiten und Therapiealgorithmen des lokal isoliert rezidivierten Rektumkarzinoms vor, die aus großen klinischen Studien sowie Erfahrungen am eigenen Krankengut bezogen wurden.

Abstract

The aim of treatment in isolated locally recurrent rectal cancer is R0 resection, which is possible in 30%. Because of the high rate of surgical complications after repeat surgery in the pelvis, preoperative staging has to be precise to estimate the extent and location of the recurrent rectal cancer. After exclusion of distant metastases, surgery should be considered following preoperative radiochemotherapy if possible. When a curative treatment concept is not indicated, radiotherapy is the best treatment choice. This paper presents various tabularised summaries about therapeutic strategies in isolated locally recurrent rectal cancer.

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Authors and Affiliations

  1. Klinik für Chirurgie und Chirurgische Onkologie, Robert-Rössle-Klinik im Helios Klinikum Berlin, Campus Berlin Buch, Charité, Universitätsmedizin Berlin

    B. Rau

  2. Klinik für Strahlentherapie, Robert-Rössle-Klinik im Helios Klinikum Berlin, Campus Berlin Buch,Charité,Universitätsmedizin Berlin

    S. Koswig

  3. Klinik für Strahlenheilkunde, Campus Virchow-Klinikum, Charité, Universitätsmedizin Berlin

    B. Gebauer & J. Gellermann

  4. Medizinische Klinik mit Schwerpunkt Hämatologie und Onkologie, Campus Virchow-Klinikum, Charité, Universitätsmedizin Berlin

    B. Hildebrandt

  5. Klinik für Chirurgie und Chirurgische Onkologie, Robert-Rössle-Klinik im Helios Klinikum, Campus Berlin Buch, Charité, Universitätsmedizin, Lindenberger Weg 80, 13125, Berlin

    B. Rau

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Rau, B., Koswig, S., Gebauer, B. et al. Therapieprinzipien beim Lokalrezidiv des Rektumkarzinoms. Onkologe 11, 840–849 (2005). https://doi.org/10.1007/s00761-005-0905-6

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