Chirurgische und interventionelle Therapie kolorektaler Lebermetastasen

Durch diagnostische und therapeutische Fortschritte konnten die Behandlungsergebnisse metastasierter kolorektaler Karzinome deutlich verbessert werden. Im Vordergrund steht die Notwendigkeit einer kurativen Resektion in sano. Klinisch pathologische Faktoren wie Größe, Anzahl der Metastasen und extrahepatische Tumormanifestation sind keine Kontraindikation für eine Leberresektion. Bei Patienten mit resektablen Lebermetastasen kann eine neoadjuvante/perioperative oder adjuvante Chemotherapie eingesetzt werden. Für Patienten mit initial nicht resektablen, jedoch potenziell resektablen Lebermetastasen sollte eine möglichst biologisch hochaktive Induktionschemotherapie – so kurz wie möglich, so lange wie nötig – mit dem Therapieziel der Konversion zur Resektabilität der Metastasen erreicht werden.

Der Stellenwert der übrigen interventionellen Verfahren ist derzeitig noch nicht validiert.

• Literatur

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