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Allgemein- und Viszeralchirurgie up2date 2016; 10(03): 223-240
DOI: 10.1055/s-0041-111391
Leber, Galle, Pankreas, Milz
Georg Thieme Verlag KG Stuttgart · New York

Chirurgische und interventionelle Therapie kolorektaler Lebermetastasen

M. Binnebösel
Klinik für Allgemein-, Viszeral- und Transplantationschirurgie, Uniklinik der RWTH Aachen
,
C. D. Klink
Klinik für Allgemein-, Viszeral- und Transplantationschirurgie, Uniklinik der RWTH Aachen
,
U. P. Neumann
Klinik für Allgemein-, Viszeral- und Transplantationschirurgie, Uniklinik der RWTH Aachen
› Author Affiliations
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Publication History

Publication Date:
06 June 2016 (online)

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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.

 

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