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Surgical management of cancer of the colon

Chirurgische Therapie des Kolonkarzinoms

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Zusammenfassung

GRUNDLAGEN: Die Inzidenz des Kolonkarzinoms hat in den letzten Jahren zugenommen. Ebenso haben sich in den letzten Jahren neue diagnostische und therapeutische Methoden entwickelt. METHODIK: Übersicht zum Management des Kolonkarzinoms. ERGEBNISSE: Die chirurgische Therapie des Kolonkarzinoms bietet bei einer R0-Resektion die einzige Heilungschance. Im fortgeschrittenen Tumorstadium kann die Prognose durch eine Chemotherapie verbessert werden, die Effizienz neoadjuvanter Maßnahmen wurde bisher beim Kolonkarzinom nicht nachgewiesen. Unter dem Gesichtspunkt der intramuralen mikroskopischen Tumorwachstumsausbreitung ist bei den zirkulär wachsenden Kolonkarzinomen ein Sicherheitsabstand von 5 cm ausreichend. Das Ausmaß der Darmresektion wird durch die Resektion der versorgenden Gefäße und das hierdurch definierte Lymphabflussgebiet vorgegeben. Die Prognose des Kolonkarzinoms hängt in erster Linie vom Stadium bei der Diagnosestellung und von der Erfahrung des onkologischen Chirurgen ab. Wichtig für die Prognose sind besonders T-, N- und M-Stadium und das Grading. Die Bedeutung molekularer Marker des Tumorgewebes und des Serums werden derzeit noch diskutiert. SCHLUSSFOLGERUNGEN: Bei radikaler chirurgische Therapie kann auch beim Kolonkarzinom ein gutes onkologisches Ergebnis erzielt werden.

Summary

BACKGROUND: The incidence of colon carcinoma has increased during the last years, but novel diagnostic tools have also been developed. METHODS: Review on colon carcinoma. RESULTS: The only chance in the cure of colonic carcinoma is achieved by radical surgery (R0-resection). Prognosis of advanced carcinomas may improve with chemotherapy, although the efficiency of neoadjuvant designs has not yet been confirmed. Taking into account the intramural microscopic tumor spread, a safety margin of 5 cm seems to be sufficient for circumferentially growing tumors. The extent of colonic resection is defined by the resection of the blood vessels as well as its lymphovascular excision. Prognosis of colonic cancer depends on the tumor stage at the time of diagnosis as well as on the experience of the operating surgeon. In addition, TNM stage and tumor grading are very important factors, too, regarding prognosis. The impact of molecular markers of tumor tissue and serum are still being discussed. CONCLUSIONS: Radical surgical resection can yield good results in the treatment of colon carcinoma.

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Authors and Affiliations

  1. Division of General Surgery, Department of Surgery, Medical University of Vienna, Vienna, Austria

    B. Teleky & Irene Kührer

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  1. B. Teleky
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  2. Irene Kührer
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Correspondence to B. Teleky.

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Teleky, B., Kührer, I. Surgical management of cancer of the colon. Eur Surg 38, 124–128 (2006). https://doi.org/10.1007/s10353-006-0239-7

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  • DOI: https://doi.org/10.1007/s10353-006-0239-7

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