Skip to main content
Home
Zeitschriften
Zeitungen
Podcast
Gesundheitspolitik
Praxis
Allerlei
Jobs
Fachgebiete
Allgemeinmedizin Anästhesiologie & Intensivmedizin Apotheke Augenheilkunde Chirurgie Dermatologie Gynäkologie und Geburtshilfe HNO Innere Medizin Kinder & Jugendheilkunde Neurologie & Psychiatrie Orthopädie & Unfallchirurgie Pflege Urologie Zahnmedizin
Subfächer Innere Medizin
Diabetologie Gastroenterologie Infektiologie Kardiologie Onkologie und Hämatologie Pneumologie Rheumatologie
Fortbildungen
Überblick Fortbildungen DFP-Literaturstudium-Artikel DFP-Webcast Fortbildungen DFP-Podcasts
Erweiterte Suche
Anmelden
nach oben
Schweizer Gastroenterologie
Erschienen in:

30.09.2022 | Originalien

Diagnostik und Therapie des Kolonkarzinoms

verfasst von: Ursula Bisang, Jonas Zeitz, Stefan Groth, Matthias von Allmen, Paul Magnus Schneider, PD Dr. med. Panagiotis Samaras

Erschienen in: Schweizer Gastroenterologie | Ausgabe 4/2022

Einloggen, um Zugang zu erhalten

Zusammenfassung

In den vergangenen Jahren konnten wichtige neue Erkenntnisse zur Diagnose und Therapie des Kolonkarzinoms gewonnen werden, beginnend bei der Vorsorge und Früherkennung, über endoskopische und chirurgische Therapiestrategien bis hin zu onkologischen Behandlungen sowohl lokalisierter als auch fortgeschrittener Tumorstadien. Von entscheidender Bedeutung zur Entwicklung einer optimalen Behandlungsstrategie für jeden Patienten ist eine enge interdisziplinäre Zusammenarbeit aller beteiligten Fachdisziplinen. Dieses Review soll die aktuellen Therapiekonzepte beim Kolonkarzinom auf der Basis aktueller Studiendaten aufzeigen. Die Behandlung des Rektumkarzinoms unterscheidet sich im Vorgehen vom Kolonkarzinom und wird in diesem Artikel nicht behandelt.
Vorheriger Artikel Editoriale
Nächster Artikel Helicobacter pylori – Update 2022
Literatur
1.
2.
3.
Missiaglia E, Jacobs B, D’Ario G, Di Narzo AF, Soneson C, Budinska E et al (2014) Distal and proximal colon cancers differ in terms of molecular, pathological, and clinical features. Ann Oncol 25(10):1995–2001CrossRef
4.
Glebov OK, Rodriguez LM, Nakahara K, Jenkins J, Cliatt J, Humbyrd CJ et al (2003) Distinguishing right from left colon by the pattern of gene expression. Cancer Epidemiol Biomark Prev 12(8):755–762
5.
Petrelli F, Tomasello G, Borgonovo K, Ghidini M, Turati L, Dallera P et al (2017) Prognostic survival associated with left-sided vs right-sided colon cancer: a systematic review and meta-analysis. JAMA Oncol 3(2):211–219CrossRef
6.
Lee MS, Menter DG, Kopetz S (2017) Right versus left colon cancer biology: integrating the consensus molecular subtypes. J Natl Compr Cancer Netw 15(3):411–419CrossRef
7.
Yamauchi M, Morikawa T, Kuchiba A, Imamura Y, Qian ZR, Nishihara R et al (2012) Assessment of colorectal cancer molecular features along bowel subsites challenges the conception of distinct dichotomy of proximal versus distal colorectum. Gut 61(6):847–854CrossRef
8.
Kaminski MF, Regula J, Kraszewska E, Polkowski M, Wojciechowska U, Didkowska J et al (2010) Quality indicators for colonoscopy and the risk of interval cancer. N Engl J Med 362(19):1795–1803CrossRef
9.
Qumseya BJ, Wallace MB (2012) Advanced colorectal polyp detection techniques. Curr Gastroenterol Rep 14(5):414–420CrossRef
10.
Barua I, Vinsard DG, Jodal HC, Løberg M, Kalager M, Holme Ø et al (2021) Artificial intelligence for polyp detection during colonoscopy: a systematic review and meta-analysis. Endoscopy 53(03):277–284CrossRef
11.
Balmaña J, Balaguer F, Cervantes A, Arnold D, ESMO Guidelines Working Group (2013) Familial risk-colorectal cancer: ESMO clinical practice guidelines. Ann Oncol 24(Suppl 6):vi73–vi80CrossRef
12.
Wittekind C (2010) TNM Klassifikation maligner Tumoren, 7. Aufl. Wiley, Weinheim
13.
Wittekind C (2017) TNM-Klassifikation maligner Tumoren, 8. Aufl. VCH
14.
Pohl H, Srivastava A, Bensen SP, Anderson P, Rothstein RI, Gordon SR et al (2013) Incomplete polyp resection during colonoscopy-results of the complete adenoma resection (CARE) study. Gastroenterology 144(1):74–80.e1CrossRef
15.
Thoguluva Chandrasekar V, Spadaccini M, Aziz M, Maselli R, Hassan S, Fuccio L et al (2019) Cold snare endoscopic resection of nonpedunculated colorectal polyps larger than 10 mm: a systematic review and pooled-analysis. Gastrointest Endosc 89(5):929–936.e3CrossRef
16.
Chandan S, Facciorusso A, Ramai D, Deliwala S, Mohan BP, Kassab LL et al (2022) Snare tip soft coagulation (STSC) after endoscopic mucosal resection (EMR) of large (> 20 mm) non pedunculated colorectal polyps: a systematic review and meta-analysis. Endosc Int Open 10(01):E74–E81CrossRef
17.
Moss A, Williams SJ, Hourigan LF, Brown G, Tam W, Singh R et al (2015) Long-term adenoma recurrence following wide-field endoscopic mucosal resection (WF-EMR) for advanced colonic mucosal neoplasia is infrequent: results and risk factors in 1000 cases from the Australian Colonic EMR (ACE) study. Gut 64(1):57–65CrossRef
18.
Bosch SL, Teerenstra S, de Wilt JHW, Cunningham C, Nagtegaal ID (2013) Predicting lymph node metastasis in pT1 colorectal cancer: a systematic review of risk factors providing rationale for therapy decisions. Endoscopy 45(10):827–834CrossRef
19.
Takezawa T, Hayashi Y, Shinozaki S, Sagara Y, Okada M, Kobayashi Y et al (2019) The pocket-creation method facilitates colonic endoscopic submucosal dissection (with video). Gastrointest Endosc 89(5):1045–1053CrossRef
20.
Thorlacius H, Rönnow CF, Toth E (2019) European experience of colorectal endoscopic submucosal dissection: a systematic review of clinical efficacy and safety. Acta Oncol 58(sup1):S10–S14CrossRef
21.
Aepli P, Criblez D, Baumeler S, Borovicka J, Frei R (2018) Endoscopic full thickness resection (EFTR) of colorectal neoplasms with the full thickness resection device (FTRD): clinical experience from two tertiary referral centers in Switzerland. United Eur Gastroenterol J 6(3):463–470CrossRef
22.
Kuellmer A, Mueller J, Caca K, Aepli P, Albers D, Schumacher B et al (2019) Endoscopic full-thickness resection for early colorectal cancer. Gastrointest Endosc 89(6):1180–1189.e1CrossRef
23.
Hürtgen SM, Schmitz G, Junge K, Breuer E, Tischendorf JJW (2019) Perforation as a delayed complication after endoscopic full-thickness resection in a recurrent adenoma of the sigmoid. Z Gastroenterol 57(2):156–159
24.
Schmidt A, Beyna T, Schumacher B, Meining A, Richter-Schrag HJ, Messmann H et al (2018) Colonoscopic full-thickness resection using an over-the-scope device: a prospective multicentre study in various indications. Gut 67(7):1280–1289CrossRef
25.
Köhler L, Eypasch E, Paul A, Troidl H (1997) Myths in management of colorectal malignancy. Br J Surg 84(2):248–251
26.
Wells KO, Hawkins AT, Krishnamurthy DM, Dharmarajan S, Glasgow SC, Hunt SR et al (2017) Omission of adjuvant chemotherapy is associated with increased mortality in patients with T3N0 colon cancer with inadequate lymph node harvest. Dis Colon Rectum 60(1):15–21CrossRef
27.
Roth AD, Delorenzi M, Tejpar S, Yan P, Klingbiel D, Fiocca R et al (2012) Integrated analysis of molecular and clinical prognostic factors in stage II/III colon cancer. J Natl Cancer Inst 104(21):1635–1646CrossRef
28.
Quasar Collaborative Group, Gray R, Barnwell J, McConkey C, Hills RK, Williams NS et al (2007) Adjuvant chemotherapy versus observation in patients with colorectal cancer: a randomised study. Lancet 370(9604):2020–2029CrossRef
29.
Schrag D, Rifas-Shiman S, Saltz L, Bach PB, Begg CB (2002) Adjuvant chemotherapy use for Medicare beneficiaries with stage II colon cancer. J Clin Oncol 20(19):3999–4005CrossRef
30.
Böckelman C, Engelmann BE, Kaprio T, Hansen TF, Glimelius B (2015) Risk of recurrence in patients with colon cancer stage II and III: a systematic review and meta-analysis of recent literature. Acta Oncol 54(1):5–16CrossRef
31.
André T, Boni C, Navarro M, Tabernero J, Hickish T, Topham C et al (2009) Improved overall survival with oxaliplatin, fluorouracil, and leucovorin as adjuvant treatment in stage II or III colon cancer in the MOSAIC trial. J Clin Oncol 27(19):3109–3116CrossRef
32.
Sinicrope FA, Foster NR, Thibodeau SN, Marsoni S, Monges G, Labianca R et al (2011) DNA mismatch repair status and colon cancer recurrence and survival in clinical trials of 5‑fluorouracil-based adjuvant therapy. J Natl Cancer Inst 103(11):863–875CrossRef
33.
Tejpar S, Saridaki Z, Delorenzi M, Bosman F, Roth AD (2011) Microsatellite instability, prognosis and drug sensitivity of stage II and III colorectal cancer: more complexity to the puzzle. J Natl Cancer Inst 103(11):841–844CrossRef
34.
Booth CM, Nanji S, Wei X, Peng Y, Biagi JJ, Hanna TP et al (2016) Use and effectiveness of adjuvant chemotherapy for stage III colon cancer: a population-based study. J Natl Compr Cancer Netw 14(1):47–56CrossRef
35.
André T, Meyerhardt J, Iveson T, Sobrero A, Yoshino T, Souglakos I et al (2020) Effect of duration of adjuvant chemotherapy for patients with stage III colon cancer (IDEA collaboration): final results from a prospective, pooled analysis of six randomised, phase 3 trials. Lancet Oncol 21(12):1620–1629CrossRef
36.
37.
Fong Y, Cohen AM, Fortner JG, Enker WE, Turnbull AD, Coit DG et al (1997) Liver resection for colorectal metastases. J Clin Oncol 15(3):938–946CrossRef
38.
Gonzalez M, Poncet A, Combescure C, Robert J, Ris HB, Gervaz P (2013) Risk factors for survival after lung metastasectomy in colorectal cancer patients: a systematic review and meta-analysis. Ann Surg Oncol 20(2):572–579CrossRef
39.
Mohamed F, Cecil T, Moran B, Sugarbaker P (2011) A new standard of care for the management of peritoneal surface malignancy. Curr Oncol 18(2):e84–e96CrossRef
40.
Nordlinger B, Sorbye H, Glimelius B, Poston GJ, Schlag PM, Rougier P et al (2013) Perioperative FOLFOX4 chemotherapy and surgery versus surgery alone for resectable liver metastases from colorectal cancer (EORTC 40983): long-term results of a randomised, controlled, phase 3 trial. Lancet Oncol 14(12):1208–1215CrossRef
41.
Kanemitsu Y, Shimizu Y, Mizusawa J, Inaba Y, Hamaguchi T, Shida D et al (2021) Hepatectomy followed by mFOLFOX6 versus hepatectomy alone for liver-only metastatic colorectal cancer (JCOG0603): a phase II or III randomized controlled trial. J Clin Oncol 39(34):3789–3799CrossRef
42.
Imanishi M, Yamamoto Y, Hamano Y, Yamada T, Moriwaki T, Gosho M et al (2019) Efficacy of adjuvant chemotherapy after resection of pulmonary metastasis from colorectal cancer: a propensity score-matched analysis. Eur J Cancer 106:69–77CrossRef
43.
Quénet F, Elias D, Roca L, Goéré D, Ghouti L, Pocard M et al (2021) Cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy versus cytoreductive surgery alone for colorectal peritoneal metastases (PRODIGE 7): a multicentre, randomised, open-label, phase 3 trial. Lancet Oncol 22(2):256–266CrossRef
44.
Adam R, Wicherts DA, de Haas RJ, Ciacio O, Lévi F, Paule B et al (2009) Patients with initially unresectable colorectal liver metastases: Is there a possibility of cure? J Clin Oncol 27(11):1829–1835CrossRef
45.
Falcone A, Ricci S, Brunetti I, Pfanner E, Allegrini G, Barbara C et al (2007) Phase III trial of infusional fluorouracil, leucovorin, oxaliplatin, and irinotecan (FOLFOXIRI) compared with infusional fluorouracil, leucovorin, and irinotecan (FOLFIRI) as first-line treatment for metastatic colorectal cancer: the Gruppo Oncologico Nord Ovest. J Clin Oncol 25(13):1670–1676CrossRef
46.
Cremolini C, Casagrande M, Loupakis F, Aprile G, Bergamo F, Masi G et al (2017) Efficacy of FOLFOXIRI plus bevacizumab in liver-limited metastatic colorectal cancer: a pooled analysis of clinical studies by Gruppo Oncologico del Nord Ovest. Eur J Cancer 73:74–84CrossRef
47.
Tomasello G, Petrelli F, Ghidini M, Russo A, Passalacqua R, Barni S (2017) FOLFOXIRI plus bevacizumab as conversion therapy for patients with initially unresectable metastatic colorectal cancer: a systematic review and pooled analysis. JAMA Oncol 3(7):e170278CrossRef
48.
Modest DP, Martens UM, Riera-Knorrenschild J, Greeve J, Florschütz A, Wessendorf S et al (2019) FOLFOXIRI plus panitumumab as first-line treatment of RAS wild-type metastatic colorectal cancer: the randomized, open-label, phase II VOLFI study (AIO KRK0109). J Clin Oncol 37(35):3401–3411CrossRef
49.
Tang W, Ren L, Liu T, Ye Q, Wei Y, He G et al (2020) Bevacizumab plus mFOLFOX6 versus mFOLFOX6 alone as first-line treatment for RAS mutant unresectable colorectal liver-limited metastases: the BECOME randomized controlled trial. J Clin Oncol 38(27):3175–3184CrossRef
50.
Ye LC, Liu TS, Ren L, Wei Y, Zhu DX, Zai SY et al (2013) Randomized controlled trial of cetuximab plus chemotherapy for patients with KRAS wild-type unresectable colorectal liver-limited metastases. J Clin Oncol 31(16):1931–1938CrossRef
51.
Folprecht G, Gruenberger T, Bechstein W, Raab HR, Weitz J, Lordick F et al (2014) Survival of patients with initially unresectable colorectal liver metastases treated with FOLFOX/cetuximab or FOLFIRI/cetuximab in a multidisciplinary concept (CELIM study). Ann Oncol 25(5):1018–1025CrossRef
52.
Holch JW, Ricard I, Stintzing S, Modest DP, Heinemann V (2017) The relevance of primary tumour location in patients with metastatic colorectal cancer: a meta-analysis of first-line clinical trials. Eur J Cancer 70:87–98CrossRef
53.
Jeong JH, Kim J, Hong YS, Kim D, Kim JE, Kim SY et al (2017) HER2 amplification and cetuximab efficacy in patients with metastatic colorectal cancer harboring wild-type RAS and BRAF. Clin Colorectal Cancer 16(3):e147–e152CrossRef
54.
Raghav K, Loree JM, Morris JS, Overman MJ, Yu R, Meric-Bernstam F et al (2019) Validation of HER2 amplification as a predictive biomarker for anti-epidermal growth factor receptor antibody therapy in metastatic colorectal cancer. JCO Precis Oncol 3:1–13
55.
Arnold D, Lueza B, Douillard JY, Peeters M, Lenz HJ, Venook A et al (2017) Prognostic and predictive value of primary tumour side in patients with RAS wild-type metastatic colorectal cancer treated with chemotherapy and EGFR directed antibodies in six randomized trials. Ann Oncol 28(8):1713–1729CrossRef
56.
Cremolini C, Antoniotti C, Rossini D, Lonardi S, Loupakis F, Pietrantonio F et al (2020) Upfront FOLFOXIRI plus bevacizumab and reintroduction after progression versus mFOLFOX6 plus bevacizumab followed by FOLFIRI plus bevacizumab in the treatment of patients with metastatic colorectal cancer (TRIBE2): a multicentre, open-label, phase 3, randomised, controlled trial. Lancet Oncol 21(4):497–507CrossRef
57.
Cremolini C, Antoniotti C, Stein A, Bendell J, Gruenberger T, Rossini D et al (2020) Individual patient data meta-analysis of FOLFOXIRI plus bevacizumab versus doublets plus bevacizumab as initial therapy of unresectable metastatic colorectal cancer. J Clin Oncol. https://​doi.​org/​10.​1200/​JCO.​20.​01225CrossRef
58.
Hamaguchi T, Takashima A, Mizusawa J, Shimada Y, Nagashima F, Ando M et al (2022) A randomized phase III trial of mFOLFOX7 or CapeOX plus bevacizumab versus 5‑FU/ l -LV or capecitabine plus bevacizumab as initial therapy in elderly patients with metastatic colorectal cancer: JCOG1018 study (RESPECT). J Clin Oncol 40(4_suppl):10CrossRef
59.
Cunningham D, Lang I, Marcuello E, Lorusso V, Ocvirk J, Shin DB et al (2013) Bevacizumab plus capecitabine versus capecitabine alone in elderly patients with previously untreated metastatic colorectal cancer (AVEX): an open-label, randomised phase 3 trial. Lancet Oncol 14(11):1077–1085CrossRef
60.
Feliu J, Escudero P, Llosa F, Bolaños M, Vicent JM, Yubero A et al (2005) Capecitabine as first-line treatment for patients older than 70 years with metastatic colorectal cancer: an oncopaz cooperative group study. J Clin Oncol 23(13):3104–3111CrossRef
61.
Fuchs CS, Moore MR, Harker G, Villa L, Rinaldi D, Hecht JR (2003) Phase III comparison of two irinotecan dosing regimens in second-line therapy of metastatic colorectal cancer. J Clin Oncol 21(5):807–814CrossRef
62.
Andre T, Shiu KK, Kim TW, Jensen BV, Jensen LH, Punt CJA et al (2021) Final overall survival for the phase III KN177 study: pembrolizumab versus chemotherapy in microsatellite instability-high/mismatch repair deficient (MSI-H/dMMR) metastatic colorectal cancer (mCRC). J Clin Oncol 39(15_suppl):3500CrossRef
63.
Lenz HJ, Van Cutsem E, Limon ML, Wong KYM, Hendlisz A, Aglietta M et al (2022) First-line nivolumab plus low-dose ipilimumab for microsatellite instability-high/mismatch repair-deficient metastatic colorectal cancer: the phase II checkmate 142 study. J Clin Oncol 40(2):161–170CrossRef
64.
Pietrantonio F, Morano F, Corallo S, Miceli R, Lonardi S, Raimondi A et al (2019) Maintenance therapy with panitumumab alone vs panitumumab plus fluorouracil-leucovorin in patients with RAS wild-type metastatic colorectal cancer: a phase 2 randomized clinical trial. JAMA Oncol 5(9):1268–1275CrossRef
65.
Modest DP, Karthaus M, Fruehauf S, Graeven U, Müller L, König AO et al (2022) Panitumumab plus fluorouracil and folinic acid versus fluorouracil and folinic acid alone as maintenance therapy in RAS wild-type metastatic colorectal cancer: the randomized PANAMA trial (AIO KRK 0212). J Clin Oncol 40(1):72–82CrossRef
66.
Tabernero J, Grothey A, Van Cutsem E, Yaeger R, Wasan H, Yoshino T et al (2021) Encorafenib plus cetuximab as a new standard of care for previously treated BRAF V600E-mutant metastatic colorectal cancer: updated survival results and subgroup analyses from the BEACON study. J Clin Oncol 39(4):273–284CrossRef
67.
Siena S, Di Bartolomeo M, Raghav K, Masuishi T, Loupakis F, Kawakami H et al (2021) Trastuzumab deruxtecan (DS-8201) in patients with HER2-expressing metastatic colorectal cancer (DESTINY-CRC01): a multicentre, open-label, phase 2 trial. Lancet Oncol 22(6):779–789CrossRef
Metadaten
Titel
Diagnostik und Therapie des Kolonkarzinoms
verfasst von
Ursula Bisang
Jonas Zeitz
Stefan Groth
Matthias von Allmen
Paul Magnus Schneider
PD Dr. med. Panagiotis Samaras
Publikationsdatum
30.09.2022
Verlag
Springer Vienna
Erschienen in
Schweizer Gastroenterologie / Ausgabe 4/2022
Print ISSN: 2662-7140
Elektronische ISSN: 2662-7159
DOI
https://doi.org/10.1007/s43472-022-00081-3

Weitere Artikel der Ausgabe 4/2022

Sphingosin-1-Phosphat-Rezeptor-Modulatoren bei Colitis ulcerosa – Game Changer oder einer unter vielen?

  • Open Access
  • Journal Club

Helicobacter pylori – Update 2022

  • Originalien

Éditorial

  • Éditorial

Editoriale

  • Editoriale

Editorial

  • Editorial

Liver tests: what to measure and what to do when abnormal

  • Originalien