ZUSAMMENFASSUNG
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
Keywords
Colorectal cancer - liver metastases - multimodal
