What does the general and abdominal surgeon need to know about oncologically oriented radiotherapy?

• Published in: Chirurgie (Heidelberg, Germany) Germany), 2023-05, Vol.94 (5), p.441-452
• Main Authors: Müller, Jörg Andreas, Trommer, Simon, Meyer, Frank, Lampe, Katharina, Croner, Roland S, Vordermark, Dirk, Medenwald, Daniel
• Format: Article
• Language: ger
• Subjects: Chemoradiotherapy - methods; Combined Modality Therapy; Esophageal Neoplasms - radiotherapy; Esophageal Neoplasms - surgery; Humans; Liver Neoplasms; Neoadjuvant Therapy - methods; Rectal Neoplasms - pathology; Rectal Neoplasms - radiotherapy; Rectal Neoplasms - surgery; Surgeons
• ISSN: 2731-698X
• DOI: 10.1007/s00104-023-01820-1

Radiotherapy is an integral component of most modern multimodal tumor treatment concepts, both in palliative and curative situations and intentions. This also applies to many tumor entities relevant in general as well as abdominal surgery. This can give rise to new challenges in the context of the daily clinical routine and interdisciplinary tumor conferences. Practice relevant overview, based on selective references from the current scientific literature in medicine and own experiences obtained in daily work, for the oncological surgeon on radiotherapy-associated options for visceral tumor lesions. A particular focus is on rectal cancer, esophageal cancer, anal cancer and liver metastases. A narrative review is given. In total neoadjuvant therapy it is possible to avoid resection in rectal cancer if a good response is achieved and close monitoring can be provided. In esophageal cancer neoadjuvant chemoradiotherapy followed by resection can be considered the therapeutic regimen of choice for all suitable patients. If surgery is not an option, definitive chemoradiotherapy is an appropriate and favorable alternative, especially with respect to squamous cell carcinoma. Even taking the latest data on the topic into account, definitive chemoradiotherapy remains undisputedly recommended for anal cancer. Liver tumors can be locally ablated by stereotactic radiotherapy. Close cooperation between disciplines in the context of tumor therapy remains essential for the best possible treatment and outcome of patients.