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Chirurgische Therapie von Lebermetastasen nach colorectalem Carcinom

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Colorectales Carcinom

Part of the book series: Onkologie heute ((ONKOLOGIE))

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Zusammenfassung

Lebermetastasen sind bei über 30–50% aller Patienten mit einem Malignom zu erwarten, wobei annähernd 90% aller resektablen Lebermetastasen colorectalen Ursprungs sind. In 15 bis 25% der Fälle treten colorectale Metastasen synchron und in 25 bis 30% der Patienten metachron auf. Retrospektive Untersuchungen haben gezeigt, daß ohne Behandlung die mittlere Überlebenszeit dieser Patienten ca. 24 Monate beträgt [27, 48]. Eine Verbesserung der Überlebenschancen dieser Patienten kann heute nur durch eine radikale Lebermetastasenresektion erreicht werden. Gelingt eine komplette Tumorentfernung, so kann eine durchschnittliche 5-Jahres-Überlebensrate um 30% (15–45%) erzielt werden [25]. Leider kommen nur 10–25% der Patienten für einen potentiell kurativen leberresezierenden Eingriff in Frage, da in den meisten Fällen das Tumorleiden bereits fortgeschritten ist bzw. eine okkulte Dissemination intra- und extrahepatisch vorliegt. Ein Prognosegewinn kann nur durch Ro-Resektion bei Ausschluß extrahepatischer Metastasen und eines Lokalrezidivs erreicht werden. Ziel der präoperativen diagnostischen Untersuchungen ist somit die Abklärung folgender Fragen:

  • Ist der Patient für einen radikalen Eingriff geeignet (Feasibility)?

  • Ist eine R0-Resektion der Metastasen technisch möglich (Resektabilität)?

  • Ist der Tumor nur auf die Leber beschränkt (Kurabilität)?

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Author information

Authors and Affiliations

  1. Klinik für Chirurgie und Chirurgische Onkologie, Universitätsklinikum Charité, Campus Berlin-Buch, Robert-Rössle-Klinik am Max-Delbrück-Centrum für Molekulare Medizin, Lindenberger Weg 80, D-13125, Berlin, Deutschland

    Prof. Dr. Peter M. Schlag

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  1. Prof. Dr. Peter M. Schlag
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  2. Tahar Benhidjeb
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  3. Berit Kilpert
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Editors and Affiliations

  1. Klinische Abteilung für Onkologie, Univ.-Klinik für Innere Medizin I Allgemeines Krankenhaus, Wien, Österreich

    Christoph Zielinski

  2. Klinische Abteilung für Allgemeinchirurgie, Univ.-Klinik für Chirurgie Allgemeines Krankenhaus, Wien, Österreich

    Raimund Jakesz

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© 1999 Springer-Verlag Wien

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Schlag, P.M., Benhidjeb, T., Kilpert, B. (1999). Chirurgische Therapie von Lebermetastasen nach colorectalem Carcinom. In: Zielinski, C., Jakesz, R. (eds) Colorectales Carcinom. Onkologie heute. Springer, Vienna. https://doi.org/10.1007/978-3-7091-6393-1_6

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  • DOI: https://doi.org/10.1007/978-3-7091-6393-1_6

  • Publisher Name: Springer, Vienna

  • Print ISBN: 978-3-211-83312-4

  • Online ISBN: 978-3-7091-6393-1

  • eBook Packages: Springer Book Archive

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