Skip to main content
Erschienen in:

24.01.2021 | Gastrointestinale Tumoren | Leitthema

Einfluss und Toxizität perioperativer Therapien auf die onkologische Chirurgie

verfasst von: Prof. Dr. med. Stephan Gretschel, Patrick Naumann, Georg Martin Haag

Erschienen in: Die Onkologie | Ausgabe 4/2021

Einloggen, um Zugang zu erhalten

Zusammenfassung

Hintergrund

Bei zahlreichen gastrointestinalen Tumoren, wie dem Ösophaguskarzinom, dem Magenkarzinom, dem Rektumkarzinom, sowie bei der Behandlung kolorektaler Lebermetastasen führt eine perioperative multimodale Therapie zu einer Prognoseverbesserung.

Ziel

Durch präoperative Therapien soll u. a. die Chance auf eine R0-Resektion des Tumors steigen, somit ist das Ausmaß einer histopathologischen Tumorregression von prognostischer Bedeutung. Die chirurgische Resektion ist hierbei nach wie vor zentraler Bestandteil einer kurativ intendierten Therapie.

Material und Methoden

Diese Arbeit basiert auf einer selektiven Literaturrecherche der Datenbanken PubMed, National Comprehensive Cancer Network (NCCN) und den aktuellen S3-Leitlinien zum Thema „Perioperative/neoadjuvante Chemo‑, Immun- und Radiotherapie“.

Ergebnisse

Moderne onkologische Therapiekonzepte umfassen besonders die perioperative Chemotherapie und/oder die Radiochemotherapie und erhöhen nach aktuellen Studiendaten maßgeblich die Rate der Resektabilität (generell und speziell R0), ohne die postoperative Morbidität oder Mortalität wesentlich zu erhöhen.

Schlussfolgerung

Die Auswahl und Kombination der entsprechenden multimodalen Therapieansätze erfordert eine umfassende interdisziplinäre Abstimmung hinsichtlich der zeitlichen Abfolge der Therapiemodalitäten. Daneben ist ein umfassendes Management von Nebenwirkungen essenziell. Therapiestandards unterliegen einem stetigen Wandel; der vorliegende Überblick über multimodale Therapiekonzepte und ihre Bedeutung für das chirurgische Vorgehen soll dazu beitragen, bei Therapieentscheidungen zu unterstützen.
Literatur
1.
Zurück zum Zitat Al-Batran SE, Hofheinz RD, Pauligk C et al (2016) Histopathological regression after neoadjuvant docetaxel, oxaliplatin, fluorouracil, and leucovorin versus epirubicin, cisplatin, and fluorouracil or capecitabine in patients with resectable gastric or gastro-oesophageal junction adenocarcinoma (FLOT4-AIO): results from the phase 2 part of a multicentre, open-label, randomised phase 2/3 trial. Lancet Oncol 17:1697–1708PubMedCrossRef Al-Batran SE, Hofheinz RD, Pauligk C et al (2016) Histopathological regression after neoadjuvant docetaxel, oxaliplatin, fluorouracil, and leucovorin versus epirubicin, cisplatin, and fluorouracil or capecitabine in patients with resectable gastric or gastro-oesophageal junction adenocarcinoma (FLOT4-AIO): results from the phase 2 part of a multicentre, open-label, randomised phase 2/3 trial. Lancet Oncol 17:1697–1708PubMedCrossRef
2.
Zurück zum Zitat Al-Batran SE, Homann N, Pauligk C et al (2019) Perioperative chemotherapy with fluorouracil plus leucovorin, oxaliplatin, and docetaxel versus fluorouracil or capecitabine plus cisplatin and epirubicin for locally advanced, resectable gastric or gastro-oesophageal junction adenocarcinoma (FLOT4): a randomised, phase 2/3 trial. Lancet 393:1948–1957PubMedCrossRef Al-Batran SE, Homann N, Pauligk C et al (2019) Perioperative chemotherapy with fluorouracil plus leucovorin, oxaliplatin, and docetaxel versus fluorouracil or capecitabine plus cisplatin and epirubicin for locally advanced, resectable gastric or gastro-oesophageal junction adenocarcinoma (FLOT4): a randomised, phase 2/3 trial. Lancet 393:1948–1957PubMedCrossRef
3.
Zurück zum Zitat Aloia T, Sebagh M, Plasse M et al (2006) Liver histology and surgical outcomes after preoperative chemotherapy with fluorouracil plus oxaliplatin in colorectal cancer liver metastases. J Clin Oncol 24:4983–4990PubMedCrossRef Aloia T, Sebagh M, Plasse M et al (2006) Liver histology and surgical outcomes after preoperative chemotherapy with fluorouracil plus oxaliplatin in colorectal cancer liver metastases. J Clin Oncol 24:4983–4990PubMedCrossRef
4.
Zurück zum Zitat Ansari N, Solomon MJ, Fisher RJ et al (2017) Acute adverse events and postoperative complications in a randomized trial of preoperative short-course radiotherapy versus long-course chemoradiotherapy for T3 adenocarcinoma of the rectum: Trans-Tasman Radiation Oncology Group Trial (TROG 01.04). Ann Surg 265:882–888PubMedCrossRef Ansari N, Solomon MJ, Fisher RJ et al (2017) Acute adverse events and postoperative complications in a randomized trial of preoperative short-course radiotherapy versus long-course chemoradiotherapy for T3 adenocarcinoma of the rectum: Trans-Tasman Radiation Oncology Group Trial (TROG 01.04). Ann Surg 265:882–888PubMedCrossRef
5.
Zurück zum Zitat Aschele C, Cionini L, Lonardi S et al (2011) Primary tumor response to preoperative chemoradiation with or without oxaliplatin in locally advanced rectal cancer: pathologic results of the STAR-01 randomized phase III trial. J Clin Oncol 29:2773–2780PubMedCrossRef Aschele C, Cionini L, Lonardi S et al (2011) Primary tumor response to preoperative chemoradiation with or without oxaliplatin in locally advanced rectal cancer: pathologic results of the STAR-01 randomized phase III trial. J Clin Oncol 29:2773–2780PubMedCrossRef
7.
Zurück zum Zitat Benoist S, Brouquet A, Penna C et al (2006) Complete response of colorectal liver metastases after chemotherapy: Does it mean cure? J Clin Oncol 24:3939–3945PubMedCrossRef Benoist S, Brouquet A, Penna C et al (2006) Complete response of colorectal liver metastases after chemotherapy: Does it mean cure? J Clin Oncol 24:3939–3945PubMedCrossRef
8.
Zurück zum Zitat Birgisson H, Pahlman L, Gunnarsson U et al (2007) Late adverse effects of radiation therapy for rectal cancer—a systematic overview. Acta Oncol 46:504–516PubMedCrossRef Birgisson H, Pahlman L, Gunnarsson U et al (2007) Late adverse effects of radiation therapy for rectal cancer—a systematic overview. Acta Oncol 46:504–516PubMedCrossRef
9.
Zurück zum Zitat Bokemeyer C, Bondarenko I, Makhson A et al (2009) Fluorouracil, leucovorin, and oxaliplatin with and without cetuximab in the first-line treatment of metastatic colorectal cancer. J Clin Oncol 27:663–671PubMedCrossRef Bokemeyer C, Bondarenko I, Makhson A et al (2009) Fluorouracil, leucovorin, and oxaliplatin with and without cetuximab in the first-line treatment of metastatic colorectal cancer. J Clin Oncol 27:663–671PubMedCrossRef
10.
Zurück zum Zitat Bosset JF, Calais G, Mineur L et al (2014) Fluorouracil-based adjuvant chemotherapy after preoperative chemoradiotherapy in rectal cancer: long-term results of the EORTC 22921 randomised study. Lancet Oncol 15:184–190PubMedCrossRef Bosset JF, Calais G, Mineur L et al (2014) Fluorouracil-based adjuvant chemotherapy after preoperative chemoradiotherapy in rectal cancer: long-term results of the EORTC 22921 randomised study. Lancet Oncol 15:184–190PubMedCrossRef
11.
Zurück zum Zitat Breugom AJ, Swets M, Bosset JF et al (2015) Adjuvant chemotherapy after preoperative (chemo)radiotherapy and surgery for patients with rectal cancer: a systematic review and meta-analysis of individual patient data. Lancet Oncol 16:200–207PubMedCrossRef Breugom AJ, Swets M, Bosset JF et al (2015) Adjuvant chemotherapy after preoperative (chemo)radiotherapy and surgery for patients with rectal cancer: a systematic review and meta-analysis of individual patient data. Lancet Oncol 16:200–207PubMedCrossRef
12.
Zurück zum Zitat Bridgewater JA, Pugh SA, Maishman T et al (2020) Systemic chemotherapy with or without cetuximab in patients with resectable colorectal liver metastasis (New EPOC): long-term results of a multicentre, randomised, controlled, phase 3 trial. Lancet Oncol 21:398–411PubMedPubMedCentralCrossRef Bridgewater JA, Pugh SA, Maishman T et al (2020) Systemic chemotherapy with or without cetuximab in patients with resectable colorectal liver metastasis (New EPOC): long-term results of a multicentre, randomised, controlled, phase 3 trial. Lancet Oncol 21:398–411PubMedPubMedCentralCrossRef
13.
Zurück zum Zitat Bujko K, Nowacki MP, Nasierowska-Guttmejer A et al (2006) Long-term results of a randomized trial comparing preoperative short-course radiotherapy with preoperative conventionally fractionated chemoradiation for rectal cancer. Br J Surg 93:1215–1223PubMedCrossRef Bujko K, Nowacki MP, Nasierowska-Guttmejer A et al (2006) Long-term results of a randomized trial comparing preoperative short-course radiotherapy with preoperative conventionally fractionated chemoradiation for rectal cancer. Br J Surg 93:1215–1223PubMedCrossRef
14.
Zurück zum Zitat Cedermark B, Dahlberg M, Glimelius B et al (1997) Improved survival with preoperative radiotherapy in resectable rectal cancer. N Engl J Med 336:980–987PubMedCrossRef Cedermark B, Dahlberg M, Glimelius B et al (1997) Improved survival with preoperative radiotherapy in resectable rectal cancer. N Engl J Med 336:980–987PubMedCrossRef
15.
Zurück zum Zitat Choti MA, Thomas M, Wong SL et al (2016) Surgical resection preferences and perceptions among medical oncologists treating liver metastases from colorectal cancer. Ann Surg Oncol 23:375–381PubMedCrossRef Choti MA, Thomas M, Wong SL et al (2016) Surgical resection preferences and perceptions among medical oncologists treating liver metastases from colorectal cancer. Ann Surg Oncol 23:375–381PubMedCrossRef
16.
Zurück zum Zitat Conroy T, Lamfichekh N, Etienne P‑L et al (2020) Total neoadjuvant therapy with mFOLFIRINOX versus preoperative chemoradiation in patients with locally advanced rectal cancer: final results of PRODIGE 23 phase III trial, a UNICANCER GI trial. J Clin Oncol 38:4007–4007CrossRef Conroy T, Lamfichekh N, Etienne P‑L et al (2020) Total neoadjuvant therapy with mFOLFIRINOX versus preoperative chemoradiation in patients with locally advanced rectal cancer: final results of PRODIGE 23 phase III trial, a UNICANCER GI trial. J Clin Oncol 38:4007–4007CrossRef
17.
Zurück zum Zitat Croese AD, Lonie JM, Trollope AF et al (2018) A meta-analysis of the prevalence of Low Anterior Resection Syndrome and systematic review of risk factors. Int J Surg 56:234–241PubMedCrossRef Croese AD, Lonie JM, Trollope AF et al (2018) A meta-analysis of the prevalence of Low Anterior Resection Syndrome and systematic review of risk factors. Int J Surg 56:234–241PubMedCrossRef
18.
Zurück zum Zitat Cunningham D, Allum WH, Stenning SP et al (2006) Perioperative chemotherapy versus surgery alone for resectable gastroesophageal cancer. N Engl J Med 355:11–20PubMedCrossRef Cunningham D, Allum WH, Stenning SP et al (2006) Perioperative chemotherapy versus surgery alone for resectable gastroesophageal cancer. N Engl J Med 355:11–20PubMedCrossRef
19.
Zurück zum Zitat De Baere T, Denys A, Madoff DC (2007) Preoperative portal vein embolization: indications and technical considerations. Tech Vasc Interv Radiol 10:67–78PubMedCrossRef De Baere T, Denys A, Madoff DC (2007) Preoperative portal vein embolization: indications and technical considerations. Tech Vasc Interv Radiol 10:67–78PubMedCrossRef
20.
Zurück zum Zitat Erlandsson J, Holm T, Pettersson D et al (2017) Optimal fractionation of preoperative radiotherapy and timing to surgery for rectal cancer (Stockholm III): a multicentre, randomised, non-blinded, phase 3, non-inferiority trial. Lancet Oncol 18:336–346PubMedCrossRef Erlandsson J, Holm T, Pettersson D et al (2017) Optimal fractionation of preoperative radiotherapy and timing to surgery for rectal cancer (Stockholm III): a multicentre, randomised, non-blinded, phase 3, non-inferiority trial. Lancet Oncol 18:336–346PubMedCrossRef
21.
Zurück zum Zitat Erlandsson J, Lorinc E, Ahlberg M et al (2019) Tumour regression after radiotherapy for rectal cancer—results from the randomised Stockholm III trial. Radiother Oncol 135:178–186PubMedCrossRef Erlandsson J, Lorinc E, Ahlberg M et al (2019) Tumour regression after radiotherapy for rectal cancer—results from the randomised Stockholm III trial. Radiother Oncol 135:178–186PubMedCrossRef
22.
Zurück zum Zitat Erlandsson J, Pettersson D, Glimelius B et al (2019) Postoperative complications in relation to overall treatment time in patients with rectal cancer receiving neoadjuvant radiotherapy. Br J Surg 106:1248–1256PubMedCrossRef Erlandsson J, Pettersson D, Glimelius B et al (2019) Postoperative complications in relation to overall treatment time in patients with rectal cancer receiving neoadjuvant radiotherapy. Br J Surg 106:1248–1256PubMedCrossRef
24.
Zurück zum Zitat Falcone A, Ricci S, Brunetti I et al (2007) Phase III trial of infusional fluorouracil, leucovorin, oxaliplatin, and irinotecan (FOLFOXIRI) compared with infusional fluorouracil, leucovorin, and irinotecan (FOLFIRI) as first-line treatment for metastatic colorectal cancer: the Gruppo Oncologico Nord Ovest. J Clin Oncol 25:1670–1676PubMedCrossRef Falcone A, Ricci S, Brunetti I et al (2007) Phase III trial of infusional fluorouracil, leucovorin, oxaliplatin, and irinotecan (FOLFOXIRI) compared with infusional fluorouracil, leucovorin, and irinotecan (FOLFIRI) as first-line treatment for metastatic colorectal cancer: the Gruppo Oncologico Nord Ovest. J Clin Oncol 25:1670–1676PubMedCrossRef
25.
Zurück zum Zitat Folprecht G, Gruenberger T, Bechstein WO et al (2010) Tumour response and secondary resectability of colorectal liver metastases following neoadjuvant chemotherapy with cetuximab: the CELIM randomised phase 2 trial. Lancet Oncol 11:38–47PubMedCrossRef Folprecht G, Gruenberger T, Bechstein WO et al (2010) Tumour response and secondary resectability of colorectal liver metastases following neoadjuvant chemotherapy with cetuximab: the CELIM randomised phase 2 trial. Lancet Oncol 11:38–47PubMedCrossRef
26.
Zurück zum Zitat Garcia-Aguilar J, Patil S, Kim JK et al (2020) Preliminary results of the organ preservation of rectal adenocarcinoma (OPRA) trial. J Clin Oncol 38:4008–4008CrossRef Garcia-Aguilar J, Patil S, Kim JK et al (2020) Preliminary results of the organ preservation of rectal adenocarcinoma (OPRA) trial. J Clin Oncol 38:4008–4008CrossRef
27.
Zurück zum Zitat Gerard JP, Azria D, Gourgou-Bourgade S et al (2012) Clinical outcome of the ACCORD 12/0405 PRODIGE 2 randomized trial in rectal cancer. J Clin Oncol 30:4558–4565PubMedCrossRef Gerard JP, Azria D, Gourgou-Bourgade S et al (2012) Clinical outcome of the ACCORD 12/0405 PRODIGE 2 randomized trial in rectal cancer. J Clin Oncol 30:4558–4565PubMedCrossRef
28.
Zurück zum Zitat Gerard JP, Conroy T, Bonnetain F et al (2006) Preoperative radiotherapy with or without concurrent fluorouracil and leucovorin in T3–4 rectal cancers: results of FFCD 9203. J Clin Oncol 24:4620–4625PubMedCrossRef Gerard JP, Conroy T, Bonnetain F et al (2006) Preoperative radiotherapy with or without concurrent fluorouracil and leucovorin in T3–4 rectal cancers: results of FFCD 9203. J Clin Oncol 24:4620–4625PubMedCrossRef
29.
Zurück zum Zitat Glynne-Jones R, Wyrwicz L, Tiret E et al (2018) Rectal cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 29:iv263PubMedCrossRef Glynne-Jones R, Wyrwicz L, Tiret E et al (2018) Rectal cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 29:iv263PubMedCrossRef
30.
Zurück zum Zitat Hoeppner J, Lordick F, Brunner T et al (2016) ESOPEC: prospective randomized controlled multicenter phase III trial comparing perioperative chemotherapy (FLOT protocol) to neoadjuvant chemoradiation (CROSS protocol) in patients with adenocarcinoma of the esophagus (NCT02509286). Bmc Cancer 16:503PubMedPubMedCentralCrossRef Hoeppner J, Lordick F, Brunner T et al (2016) ESOPEC: prospective randomized controlled multicenter phase III trial comparing perioperative chemotherapy (FLOT protocol) to neoadjuvant chemoradiation (CROSS protocol) in patients with adenocarcinoma of the esophagus (NCT02509286). Bmc Cancer 16:503PubMedPubMedCentralCrossRef
31.
Zurück zum Zitat Hofheinz RD, Wenz F, Post S et al (2012) Chemoradiotherapy with capecitabine versus fluorouracil for locally advanced rectal cancer: a randomised, multicentre, non-inferiority, phase 3 trial. Lancet Oncol 13:579–588PubMedCrossRef Hofheinz RD, Wenz F, Post S et al (2012) Chemoradiotherapy with capecitabine versus fluorouracil for locally advanced rectal cancer: a randomised, multicentre, non-inferiority, phase 3 trial. Lancet Oncol 13:579–588PubMedCrossRef
32.
Zurück zum Zitat Karoui M, Penna C, Amin-Hashem M et al (2006) Influence of preoperative chemotherapy on the risk of major hepatectomy for colorectal liver metastases. Ann Surg 243:1–7PubMedPubMedCentralCrossRef Karoui M, Penna C, Amin-Hashem M et al (2006) Influence of preoperative chemotherapy on the risk of major hepatectomy for colorectal liver metastases. Ann Surg 243:1–7PubMedPubMedCentralCrossRef
33.
Zurück zum Zitat Klinger M, Tamandl D, Eipeldauer S et al (2010) Bevacizumab improves pathological response of colorectal cancer liver metastases treated with XELOX/FOLFOX. Ann Surg Oncol 17:2059–2065PubMedCrossRef Klinger M, Tamandl D, Eipeldauer S et al (2010) Bevacizumab improves pathological response of colorectal cancer liver metastases treated with XELOX/FOLFOX. Ann Surg Oncol 17:2059–2065PubMedCrossRef
34.
Zurück zum Zitat Lefevre JH, Mineur L, Kotti S et al (2016) Effect of interval (7 or 11 weeks) between neoadjuvant radiochemotherapy and surgery on complete pathologic response in rectal cancer: a multicenter, randomized, controlled trial (GRECCAR-6). J Clin Oncol 34:3773–3780PubMedCrossRef Lefevre JH, Mineur L, Kotti S et al (2016) Effect of interval (7 or 11 weeks) between neoadjuvant radiochemotherapy and surgery on complete pathologic response in rectal cancer: a multicenter, randomized, controlled trial (GRECCAR-6). J Clin Oncol 34:3773–3780PubMedCrossRef
35.
Zurück zum Zitat Macfarlane JK, Ryall RD, Heald RJ (1993) Mesorectal excision for rectal cancer. Lancet 341:457–460PubMedCrossRef Macfarlane JK, Ryall RD, Heald RJ (1993) Mesorectal excision for rectal cancer. Lancet 341:457–460PubMedCrossRef
36.
Zurück zum Zitat Modest DP, Denecke T, Pratschke J et al (2018) Surgical treatment options following chemotherapy plus cetuximab or bevacizumab in metastatic colorectal cancer-central evaluation of FIRE‑3. Eur J Cancer 88:77–86PubMedCrossRef Modest DP, Denecke T, Pratschke J et al (2018) Surgical treatment options following chemotherapy plus cetuximab or bevacizumab in metastatic colorectal cancer-central evaluation of FIRE‑3. Eur J Cancer 88:77–86PubMedCrossRef
37.
Zurück zum Zitat Ngan SY, Burmeister B, Fisher RJ et al (2012) Randomized trial of short-course radiotherapy versus long-course chemoradiation comparing rates of local recurrence in patients with T3 rectal cancer: Trans-Tasman Radiation Oncology Group trial 01.04. J Clin Oncol 30:3827–3833PubMedCrossRef Ngan SY, Burmeister B, Fisher RJ et al (2012) Randomized trial of short-course radiotherapy versus long-course chemoradiation comparing rates of local recurrence in patients with T3 rectal cancer: Trans-Tasman Radiation Oncology Group trial 01.04. J Clin Oncol 30:3827–3833PubMedCrossRef
38.
Zurück zum Zitat Noordman BJ, Wijnhoven BPL, Lagarde SM et al (2018) Neoadjuvant chemoradiotherapy plus surgery versus active surveillance for oesophageal cancer: a stepped-wedge cluster randomised trial. Bmc Cancer 18:142PubMedPubMedCentralCrossRef Noordman BJ, Wijnhoven BPL, Lagarde SM et al (2018) Neoadjuvant chemoradiotherapy plus surgery versus active surveillance for oesophageal cancer: a stepped-wedge cluster randomised trial. Bmc Cancer 18:142PubMedPubMedCentralCrossRef
39.
Zurück zum Zitat Nordlinger B, Sorbye H, Glimelius B et al (2008) Perioperative chemotherapy with FOLFOX4 and surgery versus surgery alone for resectable liver metastases from colorectal cancer (EORTC Intergroup trial 40983): a randomised controlled trial. Lancet 371:1007–1016PubMedPubMedCentralCrossRef Nordlinger B, Sorbye H, Glimelius B et al (2008) Perioperative chemotherapy with FOLFOX4 and surgery versus surgery alone for resectable liver metastases from colorectal cancer (EORTC Intergroup trial 40983): a randomised controlled trial. Lancet 371:1007–1016PubMedPubMedCentralCrossRef
40.
Zurück zum Zitat Nordlinger B, Sorbye H, Glimelius B et al (2013) Perioperative FOLFOX4 chemotherapy and surgery versus surgery alone for resectable liver metastases from colorectal cancer (EORTC 40983): long-term results of a randomised, controlled, phase 3 trial. Lancet Oncol 14:1208–1215PubMedCrossRef Nordlinger B, Sorbye H, Glimelius B et al (2013) Perioperative FOLFOX4 chemotherapy and surgery versus surgery alone for resectable liver metastases from colorectal cancer (EORTC 40983): long-term results of a randomised, controlled, phase 3 trial. Lancet Oncol 14:1208–1215PubMedCrossRef
41.
Zurück zum Zitat Nordlinger B, Van Cutsem E, Gruenberger T et al (2009) Combination of surgery and chemotherapy and the role of targeted agents in the treatment of patients with colorectal liver metastases: recommendations from an expert panel. Ann Oncol 20:985–992PubMedCrossRef Nordlinger B, Van Cutsem E, Gruenberger T et al (2009) Combination of surgery and chemotherapy and the role of targeted agents in the treatment of patients with colorectal liver metastases: recommendations from an expert panel. Ann Oncol 20:985–992PubMedCrossRef
42.
Zurück zum Zitat Primrose J, Falk S, Finch-Jones M et al (2014) Systemic chemotherapy with or without cetuximab in patients with resectable colorectal liver metastasis: the New EPOC randomised controlled trial. Lancet Oncol 15:601–611PubMedCrossRef Primrose J, Falk S, Finch-Jones M et al (2014) Systemic chemotherapy with or without cetuximab in patients with resectable colorectal liver metastasis: the New EPOC randomised controlled trial. Lancet Oncol 15:601–611PubMedCrossRef
43.
Zurück zum Zitat Reynolds JV, Preston SR, O’neill B et al (2017) ICORG 10–14: NEOadjuvant trial in Adenocarcinoma of the oEsophagus and oesophagoGastric junction International Study (Neo-AEGIS). Bmc Cancer 17:401PubMedPubMedCentralCrossRef Reynolds JV, Preston SR, O’neill B et al (2017) ICORG 10–14: NEOadjuvant trial in Adenocarcinoma of the oEsophagus and oesophagoGastric junction International Study (Neo-AEGIS). Bmc Cancer 17:401PubMedPubMedCentralCrossRef
44.
Zurück zum Zitat Ribero D, Wang H, Donadon M et al (2007) Bevacizumab improves pathologic response and protects against hepatic injury in patients treated with oxaliplatin-based chemotherapy for colorectal liver metastases. Cancer 110:2761–2767PubMedCrossRef Ribero D, Wang H, Donadon M et al (2007) Bevacizumab improves pathologic response and protects against hepatic injury in patients treated with oxaliplatin-based chemotherapy for colorectal liver metastases. Cancer 110:2761–2767PubMedCrossRef
45.
Zurück zum Zitat Robinson SM, Wilson CH, Burt AD et al (2012) Chemotherapy-associated liver injury in patients with colorectal liver metastases: a systematic review and meta-analysis. Ann Surg Oncol 19:4287–4299PubMedPubMedCentralCrossRef Robinson SM, Wilson CH, Burt AD et al (2012) Chemotherapy-associated liver injury in patients with colorectal liver metastases: a systematic review and meta-analysis. Ann Surg Oncol 19:4287–4299PubMedPubMedCentralCrossRef
46.
Zurück zum Zitat Rodel C, Graeven U, Fietkau R et al (2015) Oxaliplatin added to fluorouracil-based preoperative chemoradiotherapy and postoperative chemotherapy of locally advanced rectal cancer (the German CAO/ARO/AIO-04 study): final results of the multicentre, open-label, randomised, phase 3 trial. Lancet Oncol 16:979–989PubMedCrossRef Rodel C, Graeven U, Fietkau R et al (2015) Oxaliplatin added to fluorouracil-based preoperative chemoradiotherapy and postoperative chemotherapy of locally advanced rectal cancer (the German CAO/ARO/AIO-04 study): final results of the multicentre, open-label, randomised, phase 3 trial. Lancet Oncol 16:979–989PubMedCrossRef
47.
Zurück zum Zitat Rous P, Larimore LD (1920) Relation of the portal blood to liver maintenance: a demonstration of liver atrophy conditional on compensation. J Exp Med 31:609–632PubMedPubMedCentralCrossRef Rous P, Larimore LD (1920) Relation of the portal blood to liver maintenance: a demonstration of liver atrophy conditional on compensation. J Exp Med 31:609–632PubMedPubMedCentralCrossRef
48.
Zurück zum Zitat Rubbia-Brandt L, Audard V, Sartoretti P et al (2004) Severe hepatic sinusoidal obstruction associated with oxaliplatin-based chemotherapy in patients with metastatic colorectal cancer. Ann Oncol 15:460–466PubMedCrossRef Rubbia-Brandt L, Audard V, Sartoretti P et al (2004) Severe hepatic sinusoidal obstruction associated with oxaliplatin-based chemotherapy in patients with metastatic colorectal cancer. Ann Oncol 15:460–466PubMedCrossRef
49.
Zurück zum Zitat Sauer R, Becker H, Hohenberger W et al (2004) Preoperative versus postoperative chemoradiotherapy for rectal cancer. N Engl J Med 351:1731–1740PubMedCrossRef Sauer R, Becker H, Hohenberger W et al (2004) Preoperative versus postoperative chemoradiotherapy for rectal cancer. N Engl J Med 351:1731–1740PubMedCrossRef
50.
Zurück zum Zitat Schmiegel W, Buchberger B, Follmann M et al (2017) S3-Leitlinie – Kolorektales Karzinom. Z Gastroenterol 55:1344–1498PubMedCrossRef Schmiegel W, Buchberger B, Follmann M et al (2017) S3-Leitlinie – Kolorektales Karzinom. Z Gastroenterol 55:1344–1498PubMedCrossRef
51.
Zurück zum Zitat Schnitzbauer AA, Lang SA, Goessmann H et al (2012) Right portal vein ligation combined with in situ splitting induces rapid left lateral liver lobe hypertrophy enabling 2‑staged extended right hepatic resection in small-for-size settings. Ann Surg 255:405–414PubMedCrossRef Schnitzbauer AA, Lang SA, Goessmann H et al (2012) Right portal vein ligation combined with in situ splitting induces rapid left lateral liver lobe hypertrophy enabling 2‑staged extended right hepatic resection in small-for-size settings. Ann Surg 255:405–414PubMedCrossRef
52.
Zurück zum Zitat Sebag-Montefiore D, Stephens RJ, Steele R et al (2009) Preoperative radiotherapy versus selective postoperative chemoradiotherapy in patients with rectal cancer (MRC CR07 and NCIC-CTG C016): a multicentre, randomised trial. Lancet 373:811–820PubMedPubMedCentralCrossRef Sebag-Montefiore D, Stephens RJ, Steele R et al (2009) Preoperative radiotherapy versus selective postoperative chemoradiotherapy in patients with rectal cancer (MRC CR07 and NCIC-CTG C016): a multicentre, randomised trial. Lancet 373:811–820PubMedPubMedCentralCrossRef
53.
Zurück zum Zitat Shapiro J, Van Lanschot JJB, Hulshof M et al (2015) Neoadjuvant chemoradiotherapy plus surgery versus surgery alone for oesophageal or junctional cancer (CROSS): long-term results of a randomised controlled trial. Lancet Oncol 16:1090–1098PubMedCrossRef Shapiro J, Van Lanschot JJB, Hulshof M et al (2015) Neoadjuvant chemoradiotherapy plus surgery versus surgery alone for oesophageal or junctional cancer (CROSS): long-term results of a randomised controlled trial. Lancet Oncol 16:1090–1098PubMedCrossRef
54.
Zurück zum Zitat Stockmann M, Lock JF, Riecke B et al (2009) Prediction of postoperative outcome after hepatectomy with a new bedside test for maximal liver function capacity. Ann Surg 250:119–125PubMedCrossRef Stockmann M, Lock JF, Riecke B et al (2009) Prediction of postoperative outcome after hepatectomy with a new bedside test for maximal liver function capacity. Ann Surg 250:119–125PubMedCrossRef
55.
Zurück zum Zitat Sturesson C, Keussen I, Tranberg KG (2010) Prolonged chemotherapy impairs liver regeneration after portal vein occlusion—an audit of 26 patients. Eur J Surg Oncol 36:358–364PubMedCrossRef Sturesson C, Keussen I, Tranberg KG (2010) Prolonged chemotherapy impairs liver regeneration after portal vein occlusion—an audit of 26 patients. Eur J Surg Oncol 36:358–364PubMedCrossRef
56.
Zurück zum Zitat Tanaka K, Kumamoto T, Matsuyama R et al (2010) Influence of chemotherapy on liver regeneration induced by portal vein embolization or first hepatectomy of a staged procedure for colorectal liver metastases. J Gastrointest Surg 14:359–368PubMedCrossRef Tanaka K, Kumamoto T, Matsuyama R et al (2010) Influence of chemotherapy on liver regeneration induced by portal vein embolization or first hepatectomy of a staged procedure for colorectal liver metastases. J Gastrointest Surg 14:359–368PubMedCrossRef
57.
Zurück zum Zitat Van Cutsem E, Cervantes A, Adam R et al (2016) ESMO consensus guidelines for the management of patients with metastatic colorectal cancer. Ann Oncol 27:1386–1422PubMedCrossRef Van Cutsem E, Cervantes A, Adam R et al (2016) ESMO consensus guidelines for the management of patients with metastatic colorectal cancer. Ann Oncol 27:1386–1422PubMedCrossRef
58.
Zurück zum Zitat Van Cutsem E, Kohne CH, Hitre E et al (2009) Cetuximab and chemotherapy as initial treatment for metastatic colorectal cancer. N Engl J Med 360:1408–1417PubMedCrossRef Van Cutsem E, Kohne CH, Hitre E et al (2009) Cetuximab and chemotherapy as initial treatment for metastatic colorectal cancer. N Engl J Med 360:1408–1417PubMedCrossRef
59.
Zurück zum Zitat Van Der Valk MJM, Hilling DE, Bastiaannet E et al (2018) Long-term outcomes of clinical complete responders after neoadjuvant treatment for rectal cancer in the International Watch & Wait Database (IWWD): an international multicentre registry study. Lancet 391:2537–2545PubMedCrossRef Van Der Valk MJM, Hilling DE, Bastiaannet E et al (2018) Long-term outcomes of clinical complete responders after neoadjuvant treatment for rectal cancer in the International Watch & Wait Database (IWWD): an international multicentre registry study. Lancet 391:2537–2545PubMedCrossRef
60.
Zurück zum Zitat Van Der Valk MJM, Marijnen CAM, Van Etten B et al (2020) Compliance and tolerability of short-course radiotherapy followed by preoperative chemotherapy and surgery for high-risk rectal cancer—results of the international randomized RAPIDO-trial. Radiother Oncol 147:75–83PubMedCrossRef Van Der Valk MJM, Marijnen CAM, Van Etten B et al (2020) Compliance and tolerability of short-course radiotherapy followed by preoperative chemotherapy and surgery for high-risk rectal cancer—results of the international randomized RAPIDO-trial. Radiother Oncol 147:75–83PubMedCrossRef
61.
Zurück zum Zitat Van Hagen P, Hulshof MC, Van Lanschot JJ et al (2012) Preoperative chemoradiotherapy for esophageal or junctional cancer. N Engl J Med 366:2074–2084PubMedCrossRef Van Hagen P, Hulshof MC, Van Lanschot JJ et al (2012) Preoperative chemoradiotherapy for esophageal or junctional cancer. N Engl J Med 366:2074–2084PubMedCrossRef
62.
Zurück zum Zitat Vellayappan BA, Soon YY, Ku GY et al (2017) Chemoradiotherapy versus chemoradiotherapy plus surgery for esophageal cancer. Cochrane Database Syst Rev 8:CD10511PubMed Vellayappan BA, Soon YY, Ku GY et al (2017) Chemoradiotherapy versus chemoradiotherapy plus surgery for esophageal cancer. Cochrane Database Syst Rev 8:CD10511PubMed
63.
Zurück zum Zitat Vigano L, Capussotti L, De Rosa G et al (2013) Liver resection for colorectal metastases after chemotherapy: impact of chemotherapy-related liver injuries, pathological tumor response, and micrometastases on long-term survival. Ann Surg 258:731–740 (discussion 741–732)PubMedCrossRef Vigano L, Capussotti L, De Rosa G et al (2013) Liver resection for colorectal metastases after chemotherapy: impact of chemotherapy-related liver injuries, pathological tumor response, and micrometastases on long-term survival. Ann Surg 258:731–740 (discussion 741–732)PubMedCrossRef
64.
Zurück zum Zitat Wiltink LM, Nout RA, Fiocco M et al (2015) No increased risk of second cancer after radiotherapy in patients treated for rectal or endometrial cancer in the randomized TME, PORTEC‑1, and PORTEC‑2 trials. J Clin Oncol 33:1640–1646PubMedCrossRef Wiltink LM, Nout RA, Fiocco M et al (2015) No increased risk of second cancer after radiotherapy in patients treated for rectal or endometrial cancer in the randomized TME, PORTEC‑1, and PORTEC‑2 trials. J Clin Oncol 33:1640–1646PubMedCrossRef
65.
Zurück zum Zitat Ychou M, Boige V, Pignon JP et al (2011) Perioperative chemotherapy compared with surgery alone for resectable gastroesophageal adenocarcinoma: an FNCLCC and FFCD multicenter phase III trial. J Clin Oncol 29:1715–1721PubMedCrossRef Ychou M, Boige V, Pignon JP et al (2011) Perioperative chemotherapy compared with surgery alone for resectable gastroesophageal adenocarcinoma: an FNCLCC and FFCD multicenter phase III trial. J Clin Oncol 29:1715–1721PubMedCrossRef
Metadaten
Titel
Einfluss und Toxizität perioperativer Therapien auf die onkologische Chirurgie
verfasst von
Prof. Dr. med. Stephan Gretschel
Patrick Naumann
Georg Martin Haag
Publikationsdatum
24.01.2021
Verlag
Springer Medizin
Erschienen in
Die Onkologie / Ausgabe 4/2021
Print ISSN: 2731-7226
Elektronische ISSN: 2731-7234
DOI
https://doi.org/10.1007/s00761-020-00897-1

Weitere Artikel der Ausgabe 4/2021

Die Onkologie 4/2021 Zur Ausgabe

Passend zum Thema

ANZEIGE

Synergien nutzen gegen Tumore

Lungen- und Magentumore können dank Immuntherapien deutlich besser behandelt werden. Dennoch kommt es trotzdem weiterhin häufig zum Krankheitsprogress. Welche Therapieoptionen sich in der Zweitlinie am besten eignen, haben wir für Sie zusammengefasst.

ANZEIGE

Darmkrebsreihenuntersuchungen zeigen EU-weit Erfolge

In Europa haben viele Länder dem Darmkrebs mit Hilfe von Früherkennungsprogrammen den Kampf angesagt. Es gibt einen deutlichen Zusammenhang zwischen Inzidenz und Mortalität von Darmkrebs und der Zeitspanne seit Einführung von Reihenuntersuchungen.

ANZEIGE

GI-Tumore und die Rolle von Angiogenesehemmern

Content Hub

Entdecken Sie mit praxisrelevanten Patientenfällen, kompakten Studieninhalten, informativen Experteninterviews und weiteren spannenden Inhalten, wie Sie den vielseitigen Herausforderungen bei GI-Tumoren begegnen können. Hier erfahren Sie mehr! PP-RB-DE-2009

Passend zum Thema

ANZEIGE

Pikosekundenlaser stimuliert Reparaturmechanismen der Haut

Eine beim ASLMS 2024 vorgestellte Studie mit einem 3D-Hautmodell zeigt, dass eine Pikosekunden-Laserbehandlung über den Mechanismus des „laser-induced optical breakdown“ (LIOB) die Regenerationsmechanismen der Haut stimuliert. Diese positiven Effekte von LIOB konnten durch eine Nachbehandlung mit Dexpanthenol-haltiger Salbe unterstützt und beschleunigt werden.

ANZEIGE

Wund- und Heilsalbe mit Dexpanthenol zur Tattoo-Nachsorge geeignet

Eine klinische Studie unterstreicht die Eignung der Dexpanthenol-haltigen Bepanthen® Wund- und Heilsalbe für die Nachsorge frisch tätowierter Hautstellen [1]. Dass die Gabe von Pantothenat (aktiver Metabolit von Dexpanthenol) die Aufnahme von Tattoo-Farbe in die Makrophagen steigert und so die Beständigkeit von Tätowierungen erhöhen kann, zeigte eine In-vitro-Studie [2].

ANZEIGE

Bepanthen® unterstützt bei vielen Indikationen die Regeneration der Haut

Content Hub

Bepanthen® Wund- und Heilsalbe wird heute wie bei der Einführung vor 70 Jahren erfolgreich bei kleinen Alltagsverletzungen eingesetzt. Moderne Forschung – Untersuchungen an Hautmodellen, Genexpressionsanalysen und klinische Studien – schafft darüber hinaus Evidenz für neue Anwendungsgebiete. So kann die Dexpanthenol-haltige Salbe heute z.B. zur Nachbehandlung einer Lasertherapie bei aktinischer Keratose oder Tattoo-Entfernung eingesetzt werden. Erfahren Sie hier mehr über moderne Forschung zu Bepanthen.

Bayer Vital GmbH