Management und Therapie des kolorektalen Frühkarzinoms

Abstract

Approximately 10 % of excised polyps prove be early colorectal cancer and against the background of screening coloscopy, management of this entity is crucial. Therapy is primarily guided by histopathological criteria as the depth of tumor penetration in the submucosa directly correlates with the probability of lymph node metastases. Therapy includes local removal of the lesions in low-risk situations and radical oncological surgery is warranted in high-risk situations. All methods aim at complete resection of lesions, which can be achieved by snare polypectomy, endoscopic mucosal resection and submucosal dissection. All local treatment of early colorectal cancer must be critically weighed against radical surgery taking individual patient risk factors into consideration. Adherence to clear algorithms facilitates the indications for a stage-related therapy.