Rezidive nach zytoreduktiver Chirurgie und hyperthermer intraperitonealer Chemotherapie (HIPEC) beim kolorektalen Karzinom

 

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Zusammenfassung

Einleitung: Peritoneale Rezidive nach zytoreduktiver Chirurgie (ZRC) und hyperthermer intraperitonealer Chemotherapie (HIPEC) beim peritoneal metastasierten kolorektalen Karzinom sind eine besondere Herausforderung für die chirurgische und konservative Onkologie. Methoden: Anhand der Literatur werden aktuelle chirurgische Konzepte diskutiert. Resultate: Die Mehrzahl der Patienten erleidet nach ZRC und HIPEC ein Rezidiv. Die häufigste Konsequenz ist eine palliative Chemotherapie. Inwieweit bei selektionierten Patienten eine Re-Operation mit erneuter ZRC und HIPEC gerechtfertigt ist, wird diskutiert. Schlussfolgerung: Neue Konzepte sind notwendig, um Patienten mit einem peritonealen Rezidiv möglichst frühzeitig behandeln zu können.

Abstract

Background: Peritoneal recurrences after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC) in colorectal cancer are challenges in conservative and surgical oncology. Methods: Surgical concepts are discussed in this review on the basis of the current literature. Results: The majority of patients suffer from recurrent disease after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in colorectal cancer. In most cases, a palliative chemotherapy is performed. Repeated surgery with the aim of complete cytoreduction may be done in selected cases. Conclusions: New concepts are necessary to treat patients with recurrent disease as early as possible.

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