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Erschienen in:

15.05.2018 | Strahlentherapie | CME

Nicht metastasiertes Rektumkarzinom

Kurative multimodale Therapie

verfasst von: Prof. Dr. Robert Michael Hermann, Thomas Wirth, Daniel Pöhnert, Hans Christiansen

Erschienen in: Die Onkologie | Ausgabe 6/2018

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Zusammenfassung

Die Chirurgie nimmt die Schlüsselrolle in der kurativen Therapie des Rektumkarzinoms ein. Bei Niedrigrisikokarzinomen genügt die Vollwandexzision. Fortgeschrittenere oder biologisch aggressivere Karzinome im Stadium I werden im Sinne einer total mesorektalen Exzision operiert. Karzinome im Stadium II/III des oberen Drittels werden meist wie Kolonkarzinome behandelt. Bei ausgedehntem lymphogenem Befall oder organüberschreitendem Wachstum ist eine neoadjuvante Radiochemotherapie (RCTX) vor der Operation sinnvoll. Karzinome im Stadium II/III des unteren/mittleren Drittels werden multimodal behandelt. Dabei ist die neoadjuvante RCTX effektiver als die adjuvante, bei gleichzeitig besserer Verträglichkeit. Die Operation erfolgt nach einem Intervall von 6 bis 8 Wochen. In frühen Tumorstadien mit klinisch unsicherem Lymphknotenbefall kann der Verzicht auf die neoadjuvante RCTX gerechtfertigt sein. Bei kleinen Tumoren ohne Lymphknotenmetastasen ist alternativ auch ein organerhaltendes Vorgehen möglich.
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Metadaten
Titel
Nicht metastasiertes Rektumkarzinom
Kurative multimodale Therapie
verfasst von
Prof. Dr. Robert Michael Hermann
Thomas Wirth
Daniel Pöhnert
Hans Christiansen
Publikationsdatum
15.05.2018
Verlag
Springer Medizin
Erschienen in
Die Onkologie / Ausgabe 6/2018
Print ISSN: 2731-7226
Elektronische ISSN: 2731-7234
DOI
https://doi.org/10.1007/s00761-018-0385-0

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