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Lokoregionäres Rezidiv des Rektumkarzinoms

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Zusammenfassung

Es besteht heute kein Zweifel mehr, dass die chirurgische Therapie mit kurativer Zielsetzung einen festen Platz in der Behandlung von Fernmetastasen und lokalen Rezidiven kolorektaler Karzinome hat. Dies gilt auch für das lokal rezidivierte Rektumkarzinom. Die operative Therapie ist aufwendig, doch besteht eine Aussicht auf Heilung, wenn das Rezidiv komplett entfernt werden kann. Die Induktionstherapie mit Radiochemotherapie hat die Resektabilität des Rezidives deutlich verbessert, die Morbidität der Eingriffe bleibt jedoch hoch. Dagegen ist die Mortalität mit ca. 3% akzeptabel. Nach kompletter (R0-)Resektion kann ein 5-Jahres-Überleben von etwa 25% erwartet werden.

Abstract

There is no doubt that surgical treatment with curative intent is warranted in patients with recurrent colorectal cancer. This is also true for locally recurrent rectal cancer. Operative procedures are demanding but may be curative if complete excision can be achieved. Preoperative radiochemotherapy has helped to improve resectability, but operative morbidity is still high. Procedure-related mortality on the other hand is low, at around 3%, and 25% 5-year survival can be expected after complete excision.

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Authors and Affiliations

  1. Sektion Chirurgische Onkologie, Chirurgische Universitätsklinik Heidelberg

    Th. Lehnert

  2. Chirurgische Universitätsklinik Frankfurt

    M. Golling

  3. Abt. für Allgemein- und Unfallchirurgie, Krankenhaus Wermelskirchen

    J. Buchholz

  4. Sektion Chirurgische Onkologie, Chirurgische Universitätsklinik Heidelberg, Im Neuenheimer Feld 110, 69120 , Heidelberg

    Th. Lehnert

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  1. Th. Lehnert
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  3. J. Buchholz
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Correspondence to Th. Lehnert.

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Lehnert, T., Golling, M. & Buchholz, J. Lokoregionäres Rezidiv des Rektumkarzinoms. Chirurg 75, 38–44 (2004). https://doi.org/10.1007/s00104-003-0795-3

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