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Erweiterte oder limitierte Radikalität beim vorbehandelten kolorektalen Karzinom?

Extended or Limited Surgery Following Neoadjuvant Therapy in Colorectal Cancer?

  • Conference paper
Perspektiven der Chirurgie im 21. Jahrhundert

Part of the book series: Deutsche Gesellschaft für Chirurgie ((KONGRESSBAND,volume 2000))

  • 13 Accesses

Summary

Surgery is the only curative treatment in colorectal cancer. In rectal cancer, total mesorectum excission (TME) is necessary to achieve local cure (Ro-resection). Radiotherapy reduces the local recurrence rate in locally-advanced rectal cancer, but has no influence on subclinical systemic disease. Thus, a subset of patients (40% in UICC-stage III) can not be cured even by optimal surgery. Indeed, it is unlikely that extended surgical procedures can cure systemic disease in those patients. Traumatic surgical procedures might even be harmful, if they compromise immune function, as shown in DTH (delayed-type hypersensitivity) studies.

Zusammenfassung

Die Chirurgie ist die einzige kurative Therapie des kolorektalen Karzinoms. Beim Rektumkarzinom ist die totale mesorektale Exzision (TME) erforderlich und genügend, um eine lokale Radikalität (Ro) zu erreichen. Die Bestrahlung senkt die Lokalrezidivrate beim lokal fortgeschrittenen Rektumkarzinom, nimmt jedoch keinen Einfluß auf die subklinische systemische Krankheit. So ist ein Anteil der Patienten (40% im Stadium III) auch durch optimale Chirurgie nicht zu heilen. Bei diesen Patienten kann auch ein erweiterter chirurgischer Eingriff keinen Vorteil bringen. Ein solcher Eingriff kann aber schädlich sein, wenn er die Immunabwehr schwächt, wie DTH (delayed-type hypersensitivity) Studien es belegen.

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  1. Klinik für Allgemein-,Viszeral-und Gefäßchirurgie, Otto-von-Guericke Universität Magdeburg, Leipziger Straße 44, 39120, Magdeburg, Deutschland

    H. Lippert, M. A. Reymond & N. Bien

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Lippert, H., Reymond, M.A., Bien, N. (2000). Erweiterte oder limitierte Radikalität beim vorbehandelten kolorektalen Karzinom?. In: Perspektiven der Chirurgie im 21. Jahrhundert. Deutsche Gesellschaft für Chirurgie, vol 2000. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-59573-8_36

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  • DOI: https://doi.org/10.1007/978-3-642-59573-8_36

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-41127-7

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