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Dtsch Med Wochenschr 2004; 129(17): 957-962
DOI: 10.1055/s-2004-823165
Übersichten
Chirurgie / Onkologie
© Georg Thieme Verlag Stuttgart · New York

Der Stellenwert der (neo-)adjuvanten Therapie beim Rektumkarzinom

The role of (neo-)adjuvant therapy in rectal cancerA. Ulrich1 , M. Hartel1 , J. Weitz1 , H. Friess1 , M. Büchler1
  • 1Abteilung für Allgemein-, Viszeral- und Unfallchirurgie, Ruprecht-Karls-Universität Heidelberg, Heidelberg
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Publication History

eingereicht: 23.1.2004

akzeptiert: 1.4.2004

Publication Date:
20 July 2004 (online)

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Nach Angaben des Statistischen Bundesamtes (www.gbe-bund.de) stellte das Rektumkarzinom im Jahre 1999 das vierthäufigste Karzinom unter allen Krebsneuerkrankungen bei Männern und das dritthäufigste bei Frauen dar; 22662 Bundesbürger erkrankten daran (6,6 % aller Krebsneuerkrankungen). Die Mortalitätsrate lag 1999 bei 7,9/100000 Einwohner, sank jedoch zwischen 1990 und 1999 um 15 % relativ (9,3 % vs. 7,9 %/100 000 Einwohner) (Statistisches Bundesamt).

Dies ist unter anderem auf die Verbesserung chirurgischer Resektionsverfahren mit dem Ziel der kurativen Entfernung des Tumors und Vermeidung von Lokalrezidiven zurückzuführen. Nach Einführung der totalen mesorektalen Exzision (TME) durch Heald [27] [28] konnte die Lokalrezidivrate allein durch die chirurgische Therapie auf unter 10 % reduziert werden [12] [39]. Hermanek et al. berichteten dagegen noch im Jahre 1995 in einer deutschen Multizenterstudie von einer Lokalrezidivrate von 4-55 % mit einem Median von 20 % [29]. Mittlerweile ist die TME als chirurgischer „Goldstandard” beim Rektumkarzinom etabliert.

Die Einführung der TME hat auch die Frage nach dem Stellenwert multimodaler Konzepte in der Therapie des Rektumkarzinoms neu aufgeworfen.

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Prof. Dr. med. Dr. h. c. M. W. Büchler

Chirurgische Universitätsklinik Heidelberg, Ruprecht-Karls-Universität Heidelberg

Im Neuenheimer Feld 110

69120 Heidelberg

Phone: 06221/566201

Email: markus_buechler@med.uni-heidelberg.de

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