Ergebnisse nach Resektion nichtkolorektaler, nichtneuroendokriner Lebermetastasen

Zusammenfassung

Die Behandlung von Lebermetastasen stellt eine elementare Aufgabe der Chirurgie dar. Während die Leberresektion von kolorektalen als anerkanntes Therapieverfahren gilt, ist die Datenlage bezüglich der nichtkolorektalen, nichtneuroendokrinen Lebermetastasen schwer zu interpretieren.
Anhand eines Literaturüberblickes und der in Klinik für Viszeral- und Transplantationschirurgie der Medizinischen Hochschule Hannover im Zeitraum von Januar 1994 bis Dezember 2003 durchgeführten Leberresektionen bei nichtkolorektalen, nichtneuroendokrinen Lebermetastasen werden Ergebnisse und Einflussfaktoren auf das Patienenüberleben analysiert.
Die Analyse zeigt, dass Leberresektionen auch bei nichtkolorektalen, nichtneuroendorkinen Lebermetastasen mit einem niedrigen operativen Risiko durchgeführt werden können. Unter Beachtung strenger Indikationskriterien, wie Möglichkeit der R0-Resektion, keine extrahepatische Tumormanifestation, biologischer und funktioneller Operabilität und unter Einbindung der Leberchirurgie in ein multimodales Therapiekonzept stellt die Leberresektion in individuellen Fällen eine wichtige Therapieoption dar.

Abstract

Major hepatic surgery can be performed safely and resection for metastatic disease is increasingly carried out. However, the role of liver resection for hepatic metastases from non-colorectal, non-neuroendocrine cancers remains controversial.

The aim of our study was to evaluate the centre experience with hepatic surgery for non-colorectal non-neuroendocrine liver metastases and to compare these results to the current literature.

Records of 217 patients who underwent liver resection for metastatic non-colorectal, non-neuroendocrine cancer form January 1994 to December 2003 were reviewed. Survival after liver resection in this cohort of patients is reported and factors predictive of survival are analyzed.

Our data show that liver resection for non-colorectal, non-neuroendocrine metastases can be performed with low morbidity and mortality rates similar to colorectal metastases. Primary tumour type, disease-free interval and curative resection predict those patients who benefit from hepatic resection. Therefore the indication for liver resection is one therapeutic option in a multimodal treatment concept and should be considered carefully in every single case.

Schlüsselwörter

Lebermetastasen - nichtkolorektal - Leberresektion

Key words

Liver resection - noncolorectal - hepatic metastases

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