Hepatisch metastasiertes kolorektales Karzinom

Für die multimodale Therapie des hepatisch metastasierten kolorektalen Karzinoms stehen neben der System- und der chirurgischen Therapie unterschiedliche lokalablative Verfahren zur Verfügung, die das therapeutische Spektrum maßgeblich erweitern. Die Verfügbarkeit dieser Verfahren erfordert eine hohe Kompetenz der beteiligten Partner. Eine enge interdisziplinäre Abstimmung in entsprechenden Tumorboards im Therapieverlauf ist notwendig, um eine onkologisch optimale Therapiestrategie zu entwickeln und diese auch immer wieder zu adaptieren.

Abstract

About half of all patients with colorectal carcinoma (CRC) develop metastases mainly in the liver during the course of their disease. Metastatic disease is associated with a low 5-year overall survival rate of only 5–7 %, particularly when there is no possibility of local treatment. However, if there is an opportunity to resect the metastases, especially isolated liver metastases, the chance of long-term survival is approximately 15–27 % after both primary resection or secondary resection after neoadjuvant pretreatment. Overall, long-term survival of patients with metastatic CRC has improved significantly in recent years due to a combination of modern systemic therapies, advanced liver surgery and local ablative procedures.

Of note, for the vast majority of patients, metastatic resection does not mean cure, but a significant prolongation of overall survival with a good quality of life. Chemotherapy-free intervals after metastasis resection maintain quality of life and can help to reduce toxicity.

In this review, we would like to present the “toolbox” for the multidisciplinary treatment of metastatic CRC and give recommendations how the individual modalities should be optimally used, considering tumor-specific characteristics and patient preferences.

Schlüsselwörter

Darmkrebs - Lebermetastasen - multimodale Therapie

Key words

colorectal cancer - liver metastases - multimodal

Publication History

Article published online:
05 November 2021

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