Abdominale multiviszerale Resektion beim Kolonkarzinom

Köckerling, F.; Hermanek, P.; Thom, Nina; Gall, F. P.

doi:10.1007/978-3-662-07303-2_10

Cited by 5 publications

(4 citation statements)

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“…Consequently, RC surgery is associated with higher morbidity/mortality and with higher local relapse rates than CC surgery [ 91 , 92 , 93 , 94 ]. Specific postoperative morbidity in a large prospective observational study by the “Institute for Quality Assurance, Magdeburg” involving 3756 Patients was 21.8% in resected CC patients and 29.1% in resected RC patients.…”

Section: Resultsmentioning

confidence: 99%

“…The laparoscopic learning curve in RC is higher than in CC and laparoscopic RC surgery should be performed by specialists only [ 106 , 107 ]. It must be kept in mind that due to the intraperitoneal vs. extraperitoneal location of CC vs. RC multivisceral resections in case of T4 tumors are more frequent in CC (e.g., 12.4%) than in RC (e.g., 6.9%) [ 92 , 93 ]. Since CC may turn symptomatic at a later stage emergency surgery as well is more frequent in CC (e.g., 20%) than in RC (e.g., 6%) [ 93 , 94 ].…”

Section: Resultsmentioning

confidence: 99%

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Are Colon and Rectal Cancer Two Different Tumor Entities? A Proposal to Abandon the Term Colorectal Cancer

Paschke

Jafarov

Staib

et al. 2018

IJMS

145

134

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Colon cancer (CC) and rectal cancer (RC) are synonymously called colorectal cancer (CRC). Based on our experience in basic and clinical research as well as routine work in the field, the term CRC should be abandoned. We analyzed the available data from the literature and results from our multicenter Research Group Oncology of Gastrointestinal Tumors termed FOGT to confirm or reject this hypothesis. Anatomically, the risk of developing RC is four times higher than CC, while physical activity helps to prevent CC but not RC. Obvious differences exist in molecular carcinogenesis, pathology, surgical topography and procedures, and multimodal treatment. Therefore, we conclude that CC is not the same as RC. The term “CRC” should no longer be used as a single entity in basic and clinical research as well as other areas of classification.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Are Colon and Rectal Cancer Two Different Tumor Entities? A Proposal to Abandon the Term Colorectal Cancer

Paschke

Jafarov

Staib

et al. 2018

IJMS

145

134

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“…Considering the changes in MVR-associated incidence rates, the extended resection rates will possibly increase before and after the turn of the millennium [ 5 , 13 ], [ 14 ], [ 15 ], [ 16 ]. The relative incidence of MVR listed in each study varied widely.…”

Section: Discussionmentioning

confidence: 99%

Multivisceral resection of advanced colon and rectal cancer: a prospective multicenter observational study with propensity score analysis of the morbidity, mortality, and survival

Arndt,

Lippert,

Croner

et al. 2023

Innovative Surgical Sciences

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Objectives In the surgical treatment of colorectal carcinoma (CRC), 1 in 10 patients has a peritumorous adhesion or tumor infiltration in the adjacent tissue or organs. Accordingly, multivisceral resection (MVR) must be performed in these patients. This prospective multicenter observational study aimed to analyze the possible differences between non-multivisceral resection (nMVR) and MVR in terms of early postoperative and long-term oncological treatment outcomes. We also aimed to determine the factors influencing overall survival. Methods The data of 25,321 patients from 364 hospitals who had undergone surgery for CRC (the Union for International Cancer Control stages I–III) during a defined period were evaluated. MVR was defined as (partial) resection of the tumor-bearing organ along with resection of the adherent and adjacent organs or tissues. In addition to the patients’ personal, diagnosis (tumor findings), and therapy data, demographic data were also recorded and the early postoperative outcome was determined. Furthermore, the long-term survival of each patient was investigated, and a “matched-pair” analysis was performed. Results From 2008 to 2015, the MVR rates were 9.9 % (n=1,551) for colon cancer (colon CA) and 10.6 % (n=1,027) for rectal cancer (rectal CA). CRC was more common in men (colon CA: 53.4 %; rectal CA: 62.0 %) than in women; all MVR groups had high proportions of women (53.6 % vs. 55.2 %; pairs of values in previously mentioned order). Resection of another organ frequently occurred (75.6 % vs. 63.7 %). The MVR group had a high prevalence of intraoperative (5.8 %; 12.1 %) and postoperative surgical complications (30.8 % vs. 36.4 %; each p<0.001). Wound infections (colon CA: 7.1 %) and anastomotic insufficiencies (rectal CA: 8.3 %) frequently occurred after MVR. The morbidity rates of the MVR groups were also determined (43.7 % vs. 47.2 %). The hospital mortality rates were 4.9 % in the colon CA-related MVR group and 3.8 % in the rectal CA-related MVR group and were significantly increased compared with those of the nMVR group (both p<0.001). Results of the matched-pair analysis showed that the morbidity rates in both MVR groups (colon CA: 42.9 % vs. 34.3 %; rectal CA: 46.3 % vs. 37.2 %; each p<0.001) were significantly increased. The hospital lethality rate tended to increase in the colon CA-related MVR group (4.8 % vs. 3.7 %; p=0.084), while it significantly increased in the rectal CA-related MVR group (3.4 % vs. 3.0 %; p=0.005). Moreover, the 5-year (yr) overall survival rates were 53.9 % (nMVR: 69.5 %; p<0.001) in the colon CA group and 56.8 % (nMVR: 69.4 %; p<0.001) in the rectal CA group. Comparison of individual T stages (MVR vs. nMVR) showed no significant differences in the survival outcomes (p<0.05); however, according to the matched-pair analysis, a significant difference was observed in the survival outcomes of those with pT4 colon CA (40.6 % vs. 50.2 %; p=0.017). By contrast, the local recurrence rates after MVR were not significantly different (7.0 % vs. 5.8 %; both p>0.05). The risk factors common to both tumor types were advanced age (>79 yr), pT stage, sex, and morbidity (each hazard ratio: >1; p<0.05). Conclusions MVR allows curation by R0 resection with adequate long-term survival. For colon or rectal CA, MVR tended to be associated with reduced 5-year overall survival rates (significant only for pT4 colon CA based on the MPA results), as well as, with a significant increase in morbidity rates in both tumor entities. In the overall data, MVR was associated with significant increases in hospital lethality rates, as indicated by the matched-pair analysis (significant only for rectal CA).

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“…Durch kontrollierte Studiendaten abgesichert sind die perioperative Antibiotikaprophylaxe (127 prospektiv randomisierte Studien), die mechanische Darmreinigung (n = 5), die prinzipielle Gleichwertigkeit von Stapler-und Handanastomosen (n = 15) und der fru Èhzeitige Kostaufbau (n = 3 Hinsichtlich der multiviszeralen Resektionen beim T4-Karzinom stu Ètzen sich die Erkenntnisse vor allem auf die Daten des Erlanger Krankengutes [15,16,21]. Bei Fehlen von Fernmetastasen und erreichter en-bloc-R0-Resektion werden 5-Jahresu Èberlebensraten bis 80 % angegeben [18,28,30].…”

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Evidence-based Chirurgie desKolonkarzinoms

Gastinger

Marusch²

2001

Zentralbl Chir

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Only a few therapeutic approaches in colon cancer therapy are based on controlled study results. Via an internet search using different search strategies 965 abstracts written about colon cancer therapy between 1980-2000 were analysed. Studies focussing on adjuvant therapy were not included. We found 446 retrospective, 150 prospective randomized, 151 prospective non-randomized studies and 218 review articles. Controlled study results as a scientific base are available for perioperative antibiotic prophylaxis (127 prospective randomized studies), mechanical intestinal cleansing (n = 5), a similar efficacy of stapler and hand-made anastomosis (n = 15), and the early onset of a stage-adjusted nutrition (n = 3). Our internet search shows that only a minor fraction (approximately 10%) of colon surgery is evidence based. The most important prerequisites for an appropriate surgical resection are the pathology results reflecting the degree of tumor spreading. Besides the data from controlled studies we have to take the results from prospective multi-center studies in consideration.

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Abdominale multiviszerale Resektion beim Kolonkarzinom

Cited by 5 publications

References 0 publications

Are Colon and Rectal Cancer Two Different Tumor Entities? A Proposal to Abandon the Term Colorectal Cancer

Are Colon and Rectal Cancer Two Different Tumor Entities? A Proposal to Abandon the Term Colorectal Cancer

Multivisceral resection of advanced colon and rectal cancer: a prospective multicenter observational study with propensity score analysis of the morbidity, mortality, and survival

Evidence-based Chirurgie desKolonkarzinoms

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