[Colorectal cancers: therapy of recurrences and metastases].
Recurrent disease from colorectal carcinomas is common. 25 percent of patients have apparent metastases at the time of first detection of the tumor, and at least 50% of patients die from their tumor. The aim of the postoperative follow-up of patients with carcinoma of the colon and rectum is thus to detect recurrent tumor when cure is still possible. Clinical examination and CEA-measurement is widely recommended as a reliable indicator for recurrence and metastases of colonic cancer. This may be combined with regular coloscopic surveillance for detection of anastomotic recurrences or a second colonic cancer. In case of suspicion of a recurrence or metastasis a full range of examinations should be performed to detect the site of recurrent tumor and to exclude wide spread disease. In case of a circumscribed lesion the patients may benefit from local radical resection. Patients with four or less unilateral liver metastases show a five year disease free survival reported of more than 30% and a disease free survival reported of more than 25%. Unfortunately because of wide spread misunderstanding of the potential of hepatic Rx only about 1/3 of potentially curatively resectable patients with liver metastases finally undergo liver surgery. A more active policy towards patients with colorectal disease concerning surveillance may lead to a better survival in selected cases.
Universitätsklinik für viszerale und Transplantationschirurgie, Inselspital, Bern.
W
W
Schweizer
H E
HE
Wagner
H U
HU
Baer
P
P
Gertsch
L H
LH
Blumgart
D015179:Colorectal Neoplasms / Q000601:surgery*; D003131:Combined Modality Therapy; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary* / Q000601:surgery; D008207:Lymphatic Metastasis; D009364:Neoplasm Recurrence, Local / Q000601:surgery*; D015996:Survival Rate
Kolorektale Karzinome: Therapie von Rezidiven und Metastasen.