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coloproctology

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01.06.2021 | Rektumkarzinom | CME

Rektumkarzinom

Interdisziplinäres Therapiekonzept und chirurgische Evolution

verfasst von: Dr. Martin Mitteregger, Felix Aigner

Erschienen in: coloproctology | Ausgabe 3/2021

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Zusammenfassung

Die Entwicklung der Therapie des Rektumkarzinoms innerhalb der letzten 40 Jahre kann durchaus als Erfolgsgeschichte bezeichnet werden. Einerseits hat die Einführung und zunehmende Akzeptanz von Vorsorgeuntersuchungen zur früheren Diagnostik bzw. Vermeidung maligner Läsionen geführt, andererseits haben die Verbesserung der onkologischen Chirurgie und die Einbettung in interdisziplinäre Therapiekonzepte zu einer deutlichen Prognoseverbesserung in Bezug auf das onkologische Outcome beim Rektumkarzinom geführt. Nicht zu vernachlässigen sind nach wie vor postoperative Komplikationen und funktionelle Einschränkungen nach neoadjuvanter Therapie und Rektumresektion sowie die damit verbundene Kurz- bzw. Langzeitmorbidität. Neue minimal-invasive Ansätze sowie alternative Therapiekonzepte adressieren diese Probleme mit dem Ziel einer weiteren Ergebnisoptimierung.

Gesellschaft der epidemiologischen Krebsregister in Deutschland, Robert-Koch Institut (2012) Krebs in Deutschland 2007–2008, Häufigkeiten und Trends: Darm, 8. Aufl., S 36–39

Majek O, Gondos A, Jansen L et al (2012) Survival from colorectal cancer in Germany in the early 21st century. Br J Cancer 106:1875–1880. https://doi.org/10.1038/bjc.2012.189CrossRefPubMed

Krebsstatistik Austria http://www.statistik.at/web_de/statistiken/gesundheit/krebserkrankungen/dickdarm_enddarm/index.html. Zugegriffen: 24. Sept. 2020

Krebsstatistik Schweiz http://www.bfs.admin.ch/bfs/portal/de/index/infothek/onlinedb/stattab/01.topic.9.html. Zugegriffen: 24.Sept. 2020

(2013) S3-Leitlinie Kolorektales Karzinom. http://www.awmf.org/leitlinien/detail/ll/021-007OL.html. Zugegriffen: 24. Sept. 2020

Aigner F, Gröne J, Kneist W (2020) Organerhaltende Therapie des Rektumkarzinoms. Coloproctology 42:301. https://doi.org/10.1007/s00053-020-00478-1CrossRef

Balmana J, Castells A, Cervantes A (2010) Familial colorectal cancer risk: Rectal cancer: ESMO clinical practice guidelines. Ann Oncol 21:v78–v81. https://doi.org/10.1093/annonc/mdq169CrossRefPubMed

Wittekind C, Meyer HJ (2010) TNM Klassifikation maligner Tumoren, 7. Aufl. Wiley-VCH, Weinheim

Schmoll HJ, Van Cutsem E, Stein A et al (2012) ESMO consensus guidelines for management of patients with colon and rectal cancer. A personalized approach to clinical decision making. Ann Oncol 23:2479–2516. https://doi.org/10.1093/annonc/mds236CrossRefPubMed

10.

Hong YS et al (2014) Oxaliplatin, fluorouracil, and leucovorin versus fluorouracil and leucovorin as adjuvant chemotherapy for locally advanced rectal cancer after preoperative chemoradiotherapy (ADORE): an open-label, multicentre, phase 2, randomised controlled trial. Lancet Oncol 15(11):1245–1253CrossRef

11.

Gingert C, Adamina M (2020) Coloproctology 42:317–323CrossRef

12.

https://www.sages.org/publications/guidelines/clinical-spotlight-review-transanal-minimally-invasive-surgery-tamis/. Zugegriffen: 24. Sept. 2020

13.

You YN et al (2007) Is the increasing rate of local excision for stage I rectal cancer in the United States justified?: a nationwide cohort study from the National Cancer Database. Ann Surg 245(5):726–733. https://doi.org/10.1097/01.sla.0000252590.95116.4fCrossRefPubMedPubMedCentral

14.

Kidane B et al (2015) Local resection compared with radical resection in the treatment of T1N0M0 rectal adenocarcinoma: a systematic review and meta-analysis. Dis Colon Rectum 58(1):122–140. https://doi.org/10.1097/DCR.0000000000000293CrossRefPubMed

15.

Lu JY et al (2015) Comparison of transanal endoscopic microsurgery and total mesorectal excision in the treatment of T1 rectal cancer: a meta-analysis. Plos One 10(10):e141427. https://doi.org/10.1371/journal.pone.0141427CrossRefPubMed

16.

Jones HJS, alt (2020) Quality of life after rectal-preserving treatment of rectal cancer. Eur J Surg Oncol 46(11):2050–2056. https://doi.org/10.1016/j.ejso.2020.07.018CrossRefPubMed

17.

Galandiuk S, Wieand HS, Moertel CG et al (1992) Patterns of recurrence after curative resection of carcinoma of the colon and rectum. Surgery 174:27–32

18.

Minsky BD, Mies C, Recht A et al (1988) Resectable adenocarcinoma of the rectosigmoid and rectum. I Patterns of failure and survival. Cancer 61:1408–1416CrossRef

19.

Heald RJ, Husband EM, Ryall RD (1982) The mesorectumin rectal cancer surgery—the clue to pelvic recurrence? Br J Surg 69:613–616CrossRef

20.

Enker WE, Thaler HT, Cranor ML et al (1995) Total mesorectal excision in the operative treatment of carcinoma of the rectum. J Am Coll Surg 181:335–346PubMed

21.

Aitken RJ (1996) Mesorectal excision for rectal cancer. Br J Surg 83:214–216PubMed

22.

Martling AL, Holm T, Rutqvist LE, Moran BJ, Heald RJ, Cedemark B (2000) Effect of a surgical training programme on outcome of rectal cancer in the County of Stockholm. Stockholm Colorectal Cancer Study Group. Basingstoke Bowel Cancer Research Project. Lancet 356:93–96CrossRef

23.

Leong AF (2000) Selective total mesorectal excision for rectal cancer. Dis Colon Rectum 43(9):1237–1240CrossRef

24.

Zaheer S et al (1998) Ann Surg 227(6):800–811CrossRef

25.

Rullier et al (2013) Low rectal cancer: classification and standardization of surgery. Dis Colon Rectum 56(5):560–567CrossRef

26.

Le Voyer TE et al (2003) Colon cancer survival is associated with increasing number of lymph nodes analyzed: a secondary survey of intergroup trial INT-0089. J Clin Oncol 21(15):2912–2919CrossRef

27.

Camma C et al (2000) Preoperative radiotherapy for resectable rectal cancer: a meta-analysis. JAMA 284(8):1008–1015CrossRef

28.

Colorectal Cancer Collaborative Group (2001) Adjuvant radiotherapy for rectal cancer: a systematic overview of 8,507 patients from 22 randomised trials. Lancet 358(9290):1291–1304. https://doi.org/10.1016/S0140-6736(01)06409-1CrossRef

29.

Sauer R, Fietkau R, Wittekind C et al (2003) Adjuvant vs. neoadjuvant radiochemotherapy for locally advanced rectal cancer: the German trial CAO/ARO/AIO-94. Colorectal Dis 5:406–415CrossRef

30.

Kapiteijn E, Marijnen C, Nagtegaal I et al (2001) Preoperative radiotherapy combined with total mesorectal excision for resectable rectal cancer. N Engl J Med 345(9):638–646CrossRef

31.

Bujko K 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(10):1215–1223CrossRef

32.

Birgisson H et al (2005) Adverse effects of preoperative radiation therapy for rectal cancer: long-term follow-up of the Swedish Rectal Cancer Trial. J Clin Oncol 23(34):8697–8705CrossRef

33.

Ruppert R, Kube R, Strassburg J, Lewin A, Baral J, Maurer CA, Sauer J, Junginger T, Hermanek P, Merkel S, other members of the OCUM Group (2020) Avoidance of overtreatment of rectal cancer by selective chemoradiotherapy: results of the optimized surgery and MRI-based Multimodal therapy trial. J Am Coll Surg 231(4):413–425.e2. https://doi.org/10.1016/j.jamcollsurg.2020.06.023CrossRefPubMed

34.

Kiran RP, Lian L, Lavery IC (2011) Does a subcentimeter distal resection margin adversely influence oncologic outcomes in patients with rectal cancer undergoing restorative proctectomy? Dis Colon Rectum 54(2):157–163CrossRef

35.

Rutkowski A et al (2008) Distal bowel surgical margin shorter than 1 cm after preoperative radiation for rectal cancer: is it safe? Ann Surg Oncol 15(11):3124–3131CrossRef

36.

Ha YH et al (2010) Influence of preoperative chemoradiotherapy on the number of lymph nodes retrieved in rectal cancer. Ann Surg 252(2):336–340CrossRef

37.

COLOR II Study Group, Bonjer HJ et al (2015) A randomized trial of laparoscopic versus open surgery for rectal cancer. N Engl J Med 372:1324–1332CrossRef

38.

Simillis C et al (2019) Open versus Laparoscopic versus robotic versus Transanal Mesorectal excision for rectal cancer: a systematic review and network meta-analysis. Ann Surg 270(1):59–68. https://doi.org/10.1097/SLA.0000000000003227CrossRefPubMed

39.

Vennix S (2014) Laparoscopic versus open total mesorectal excision for rectal cancer. Cochrane Database Syst Rev. https://doi.org/10.1002/14651858.CD005200.pub3CrossRefPubMed

40.

Veltcamp Helbach M (2019) Residual mesorectum on postoperative magnetic resonance imaging following transanal total mesorectal excision (TaTME) and laparoscopic total mesorectal excision (LapTME) in rectal cancer. Surg Endosc 33(1):94–102. https://doi.org/10.1007/s00464-018-6279-9CrossRefPubMed

41.

Aigner F et al (2020) Transanale totale mesorektale Exzision – Indikation, Technik, Ergebnisse. Chirurg 91(10):860–869CrossRef

42.

Jayne D et al (2017) Effect of robotic-assisted vs conventional Laparoscopic surgery on risk of conversion to open laparotomy among patients undergoing resection for rectal cancer: the ROLARR randomized clinical trial. JAMA 318(16):1569–1580 (30,33)CrossRef

43.

Katsuno H et al (2020) Robotic surgery for rectal cancer: operative technique and review of the literature. J Anus Rectum Colon 4(1):14–24. https://doi.org/10.23922/jarc.2019-037CrossRefPubMedPubMedCentral

44.

Vonk-Klaassen SM, de Vocht HM, den Ouden ME, Eddes EH, Schuurmans MJ (2016) Ostomy-related problems and their impact on quality of life of colorectal cancer ostomates: a systematic review. Qual Life Res 25(1):125–133. https://doi.org/10.1007/s11136-015-1050-3CrossRefPubMed

45.

Croese AD, Lonie JM, Trollope AF, Vangaveti VN, Ho YH (2018) A meta-analysis of the prevalence of Low Anterior Resection Syndrome and systematic review of risk factors. Int J Surg 56:234–241. https://doi.org/10.1016/j.ijsu.2018.06.031CrossRefPubMed

46.

Maas M (2010) Long-term outcome in patients with a pathological complete response after chemoradiation for rectal cancer: a pooled analysis of individual patient data. Lancet Oncol 11(9):835–844. https://doi.org/10.1016/S1470-2045(10)70172-8CrossRefPubMed

47.

Dossa F et al (2017) A watch-and-wait approach for locally advanced rectal cancer after a clinical complete response following neoadjuvant chemoradiation: a systematic review and meta-analysis. Lancet Gastroenterol Hepatol 2(7):501–513. https://doi.org/10.1016/S2468-1253(17)30074-2CrossRefPubMed

48.

Kim et al (2020) Coloproctology 42:302–308. https://doi.org/10.1007/s00053-020-00475-4CrossRef

49.

Garcia-Aguilar J et al (2015) Organ preservation for clinical T2N0 distal rectal cancer using neoadjuvant chemoradiotherapy and local excision (ACOSOG Z6041): results of an open-label, single-arm, multi-institutional, phase 2 trial. Lancet Oncol 16(15):1537–1546. https://doi.org/10.1016/S1470-2045(15)00215-6CrossRefPubMedPubMedCentral

50.

van der Valk MJM, IWWD Consortium (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(10139):2537–2545. https://doi.org/10.1016/S0140-6736(18)31078-XCrossRefPubMed

51.

Maas M et al (2015) Assessment of clinical complete response after chemoradiation for rectal cancer with digital rectal examination, endoscopy, and MRI: selection for organ-saving treatment. Ann Surg Oncol 22(12):3873–3880. https://doi.org/10.1245/s10434-015-4687-9CrossRefPubMedPubMedCentral

52.

Dattani M et al (2018) Oncological and survival outcomes in watch and wait patients with a clinical complete response after neoadjuvant chemoradiotherapy for rectal cancer: a systematic review and pooled analysis. Ann Surg 268(6):955–967. https://doi.org/10.1097/SLA.0000000000002761CrossRefPubMed

53.

Smith JJ et al (2019) Assessment of a watch-and-wait strategy for rectal cancer in patients with a complete response after neoadjuvant therapy. JAMA 5(4):e185896. https://doi.org/10.1001/jamaoncol.2018.5896CrossRef

54.

Conroy 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(15_suppl):4007. https://doi.org/10.1200/JCO.2020.38.15_suppl.4007CrossRef

55.

Hospers et al (2020) Short-course radiotherapy followed by chemotherapy before TME in locally advanced rectal cancer: the randomized RAPIDO trial. J Clin Oncol 38(15_suppl):4006–4006. https://doi.org/10.1200/JCO.2020.38.15_suppl.4006CrossRef

56.

Sturiale A, Martellucci J, Zurli L, Vaccaro C, Brusciano L, Limongelli P, Docimo L, Valeri A (2017) Long-term functional follow-up after anterior rectal resection for cancer. Int J Colorectal Dis 32(1):83–88. https://doi.org/10.1007/s00384-016-2659-6CrossRefPubMed

57.

Croese AD (2018) A meta-analysis of the prevalence of low anterior resection syndrome and systematic review of risk factors. Int J Surg 56:234–241. https://doi.org/10.1016/j.ijsu.2018.06.031CrossRefPubMed

58.

the LARS International Collaborative Group, Keane C et al (2020) International consensus definition of low anterior resection syndrome. Dis Colon Rectum 63(3):274–284. https://doi.org/10.1097/DCR.0000000000001583CrossRef

59.

Aigner et al (2020) Coloproctology 42:324–330. https://doi.org/10.1007/s00053-020-00468-3CrossRef

60.

Ma B et al (2017) What has preoperative radio(chemo)therapy brought to localized rectal cancer patients in terms of perioperative and long-term outcomes over the past decades? A systematic review and meta-analysis based on 41,121 patients. Int J Cancer 141(5):1052–1065. https://doi.org/10.1002/ijc.30805CrossRefPubMed

61.

Emmertsen KJ, Laurberg S (2012) Low anterior resection syndrome score: development and validation of a symptom-based scoring system for bowel dysfunction after low anterior resection for rectal cancer. Ann Surg 255:922CrossRef

62.

Ramage L, Qiu S, Kontovounisios C, Tekkis P, Rasheed S, Tan E (2015) A systematic review of sacral nerve stimulation for low anterior resection syndrome. Colorectal Dis 17(9):762–771. https://doi.org/10.1111/codi.12968CrossRefPubMed

63.

Pachler J (2005) Quality of life after rectal resection for cancer, with or without permanent colostomy. Cochrane Database Syst Rev. https://doi.org/10.1002/14651858.CD004323.pub3CrossRefPubMed

Titel: Rektumkarzinom
Interdisziplinäres Therapiekonzept und chirurgische Evolution
verfasst von: Dr. Martin Mitteregger
Felix Aigner
Publikationsdatum: 01.06.2021
Verlag: Springer Medizin
Schlagwörter: Rektumkarzinom
Rektumkarzinom
Erschienen in: coloproctology / Ausgabe 3/2021
Print ISSN: 0174-2442
Elektronische ISSN: 1615-6730
DOI: https://doi.org/10.1007/s00053-021-00541-5

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