Operative Therapie kolorektaler Lebermetastasen – Multimodale Zentrumschirurgie

Die operative Entfernung von kolorektalen Lebermetastasen ist der einzige kurative Therapieansatz für diese Erkrankung. Das Vorgehen hängt dabei von der Ausprägung der Lebermetastasierung und der Konstitution des Patienten ab. Oft kommen multimodale Therapiekonzepte zur Anwendung, die eine hohe Expertise erfordern – somit ist in jedem Fall eine interdisziplinäre Konsensentscheidung zur Festlegung der optimalen Therapiestrategie notwendig.

Kernaussagen

• Die Resektion von kolorektalen Lebermetastasen geht mit einer Prognoseverbesserung einher.

• Die Kombination von Resektion, lokal ablativen Verfahren und Chemotherapie im Rahmen von multimodalen Therapiekonzepten kann die Prognose verbessern.

• Um eine Resektabilität zu erreichen, kann es notwendig sein, das zu kleine künftige Restlebergewebe mittels verschiedener Verfahren zu vergrößern (z. B. Pfortaderembolisation, ALPPS).

• Die Einschätzung der potenziellen Resektabilität ist sehr unterschiedlich und sollte daher an einem Leberzentrum getroffen werden.

• Die Behandlung von kolorektalen Lebermetastasen basiert auf interdisziplinären Tumorboard-Entscheidungen und sollte während der Therapie regelmäßig überprüft werden.

Schlüsselwörter

Lebermetastasen - kolorektales Karzinom - Leberchirurgie - multimodale Therapie

Publication History

Article published online:
29 September 2025

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