Skip to main content
SpringerLink
Log in
Book cover

MRT-basierte Chirurgie des Rektumkarzinoms pp 79–88Cite as

Optionen der neoadjuvanten Therapie beim Rektumkarzinom

  • Chapter
  • First Online:

  • 1019 Accesses

Zusammenfassung

Die Therapie des Rektumkarzinoms erfolgt heute risikostratifiziert. Eine genaue Kenntnis über die Ausdehnung und Lokalisation ist hierfür eine wesentliche Voraussetzung. Hauptpfeiler der Therapie im lokalisierten Stadium ist die kurative Resektion. Für Rektumkarzinome im Stadium II und III spielt heute im Rahmen multimodaler Therapiekonzepte die neoadjuvante Fluoropyrimidin-basierte Radiochemotherapie eine wesentliche Rolle. Sie hat maßgeblich neben der TME (totale mesorektale Exzision)-Chirurgie zur Verringerung der Rate an Lokalrezidiven, nicht jedoch der Rate an Fernmetastasen beigetragen. Es werden sowohl die aktuellen Therapiestandards unter Berücksichtigung der Studien, die diese geprägt haben, als auch neuere Therapieansätze dargestellt. Sie zielen darauf ab, die therapieassoziierte Morbidität und die Fernmetastasierungsrate zu reduzieren.

This is a preview of subscription content, log in via an institution.

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   99.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD   129.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

Literatur

  • Allegra CJ et al (2015) Neoadjuvant 5-FU or capecitabine plus radiation with or without oxaliplatin in rectal cancer patients: a phase III randomized clinical trial. J Natl Cancer Inst 107(11):djv248 doi: 10.1093/jnci/djv248

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  • Andre T et al (2015) Adjuvant Fluorouracil, Leucovorin, and Oxaliplatin in stage II to III colon cancer: updated 10-year survival and outcomes according to BRAF mutation and mismatch repair status of the MOSAIC study. J Clin Oncol 33(35):4176–4187

    Article  CAS  PubMed  Google Scholar 

  • Aschele C et al (2011) Primary tumor response to preoperative chemoradiation with or without oxaliplatin in locally advanced rectal cancer: pathologic results of the STAR-01 randomized phase III trial. J Clin Oncol 29(20):2773–2780

    Article  CAS  PubMed  Google Scholar 

  • Aschele C et al (2016) Final results of STAR-01: a randomized phase III trial comparing preoperative chemoradiation with or without oxaliplatin in locally advanced rectal cancer. J Clin Oncol 34(15):3521–3521.

    Google Scholar 

  • Bernier L et al (2018) Watch-and-wait as a therapeutic strategy in rectal cancer. Curr Colorectal Cancer Rep 14(2):37–55

    Article  PubMed  PubMed Central  Google Scholar 

  • Bertolini F et al (2009) Neoadjuvant treatment with single-agent cetuximab followed by 5-FU, cetuximab, and pelvic radiotherapy: a phase II study in locally advanced rectal cancer. Int J Radiat Oncol Biol Phys 73(2):466–472

    Article  CAS  PubMed  Google Scholar 

  • Bonner JA et al (2010) Radiotherapy plus cetuximab for locoregionally advanced head and neck cancer: 5-year survival data from a phase 3 randomised trial, and relation between cetuximab-induced rash and survival. Lancet Oncol 11(1):21–28

    Article  CAS  PubMed  Google Scholar 

  • Bosset JF et al (2006) Chemotherapy with preoperative radiotherapy in rectal cancer. N Engl J Med 355(11):1114–1123

    Article  CAS  PubMed  Google Scholar 

  • Bosset JF et al (2014) Fluorouracil-based adjuvant chemotherapy after preoperative chemoradiotherapy in rectal cancer: long-term results of the EORTC 22921 randomised study. Lancet Oncol 15(2):184–190

    Article  CAS  PubMed  Google Scholar 

  • Breugom AJ et al (2015a) Adjuvant chemotherapy after preoperative (chemo)radiotherapy and surgery for patients with rectal cancer: a systematic review and meta-analysis of individual patient data. Lancet Oncol 16(2):200–207

    Article  CAS  PubMed  Google Scholar 

  • Breugom AJ et al (2015b) Adjuvant chemotherapy for rectal cancer patients treated with preoperative (chemo)radiotherapy and total mesorectal excision: a Dutch Colorectal Cancer Group (DCCG) randomized phase III trial. Ann Oncol 26(4):696–701

    Article  CAS  PubMed  Google Scholar 

  • Bujko K et al (2006) Long-term results of a randomized trial comparing preoperative short-course radiotherapy with preoperative conventionally fractionated chemoradiation for rectal cancer. Br J Surg 93(10):1215–1223

    Article  CAS  PubMed  Google Scholar 

  • Bujko K et al (2013) Preoperative radiotherapy and local excision of rectal cancer with immediate radical re-operation for poor responders: a prospective multicentre study. Radiother Oncol 106(2):198–205

    Article  PubMed  Google Scholar 

  • Bujko K et al (2015) Postoperative chemotherapy in patients with rectal cancer receiving preoperative radio(chemo)therapy: A meta-analysis of randomized trials comparing surgery +/− a fluoropyrimidine and surgery + a fluoropyrimidine +/− oxaliplatin. Eur J Surg Oncol 41(6):713–723

    Article  CAS  PubMed  Google Scholar 

  • Bujko K et al (2016) Long-course oxaliplatin-based preoperative chemoradiation versus 5 × 5 Gy and consolidation chemotherapy for cT4 or fixed cT3 rectal cancer: results of a randomized phase III study. Ann Oncol 27(5):834–842

    Article  CAS  PubMed  Google Scholar 

  • Chua YJ et al (2010) Neoadjuvant capecitabine and oxaliplatin before chemoradiotherapy and total mesorectal excision in MRI-defined poor-risk rectal cancer: a phase 2 trial. Lancet Oncol 11(3):241–248

    Article  CAS  PubMed  Google Scholar 

  • De Felice F et al (2017) Clinical benefit of adding oxaliplatin to standard neoadjuvant chemoradiotherapy in locally advanced rectal cancer: a meta-analysis: Oxaliplatin in neoadjuvant treatment for rectal cancer. BMC Cancer 17(1):325

    Article  PubMed  PubMed Central  Google Scholar 

  • Deng Y et al (2016) Modified FOLFOX6 with or without radiation versus fluorouracil and leucovorin with radiation in neoadjuvant treatment of locally advanced rectal cancer: initial results of the chinese FOWARC multicenter, open-label, randomized three-arm phase III trial. J Clin Oncol 34(27):3300–3307

    Article  CAS  PubMed  Google Scholar 

  • Deutsche Krebsgesellschaft DK (2017) Leitlinienprogramm Onkologie, AWMF, S3-Leitlinie Kolorektales Karzinom, Langversion 2.0, AWMF-Registernummer: 021/007OL. http://www.awmf.org/leitlinien/detail/ll/021-007OL.html

  • Dewdney A et al (2012) Multicenter randomized phase II clinical trial comparing neoadjuvant oxaliplatin, capecitabine, and preoperative radiotherapy with or without cetuximab followed by total mesorectal excision in patients with high-risk rectal cancer (EXPERT-C). J Clin Oncol 30(14):1620–1627

    Article  CAS  PubMed  Google Scholar 

  • Dossa F et al (2017) A watch-and-wait approach for locally advanced rectal cancer after a clinical complete response following neoadjuvant chemoradiation: a systematic review and meta-analysis. Lancet Gastroenterol Hepatol 2(7):501–513

    Article  PubMed  Google Scholar 

  • Douillard JY et al (2010) Randomized, phase III trial of panitumumab with infusional fluorouracil, leucovorin, and oxaliplatin (FOLFOX4) versus FOLFOX4 alone as first-line treatment in patients with previously untreated metastatic colorectal cancer: the PRIME study. J Clin Oncol 28(31):4697–4705

    Article  CAS  PubMed  Google Scholar 

  • Eisterer WM et al (2009) Neoadjuvant chemoradiation therapy with capecitabine (X) plus cetuximab (C), and external beam radiotherapy (RT) in locally advanced rectal cancer (LARC): ABCSG trial R03. J Clin Oncol 27(15): 4109–4109.

    Google Scholar 

  • Erlandsson J et al (2017) Optimal fractionation of preoperative radiotherapy and timing to surgery for rectal cancer (Stockholm III): a multicentre, randomised, non-blinded, phase 3, non-inferiority trial. Lancet Oncology 18(3):336–346

    Article  PubMed  Google Scholar 

  • Fernandez-Martos C et al (2015) Chemoradiation, surgery and adjuvant chemotherapy versus induction chemotherapy followed by chemoradiation and surgery: long-term results of the Spanish GCR-3 phase II randomized trialdagger. Ann Oncol 26(8):1722–1728

    Article  CAS  PubMed  Google Scholar 

  • Folkesson J et al (2005) Swedish rectal cancer trial: long lasting benefits from radiotherapy on survival and local recurrence rate. J Clin Oncol 23(24):5644–5650

    Article  PubMed  Google Scholar 

  • Fu XL et al (2017) Meta-analysis of oxaliplatin-based versus fluorouracil-based neoadjuvant chemoradiotherapy and adjuvant chemotherapy for locally advanced rectal cancer. Oncotarget 8(21):34340–34351

    PubMed  PubMed Central  Google Scholar 

  • Garcia-Aguilar J et al (2015) Effect of adding mFOLFOX6 after neoadjuvant chemoradiation in locally advanced rectal cancer: a multicentre, phase 2 trial. Lancet Oncol 16(8):957–966

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Gerard JP et al (2006) Preoperative radiotherapy with or without concurrent fluorouracil and leucovorin in T3-4 rectal cancers: results of FFCD 9203. J Clin Oncol 24(28):4620–4625

    Article  PubMed  Google Scholar 

  • Gerard JP et al (2010) Comparison of two neoadjuvant chemoradiotherapy regimens for locally advanced rectal cancer: results of the phase III trial ACCORD 12/0405-Prodige 2. J Clin Oncol 28(10):1638–1644

    Article  CAS  PubMed  Google Scholar 

  • Gerard JP et al (2012) Clinical outcome of the ACCORD 12/0405 PRODIGE 2 randomized trial in rectal cancer. J Clin Oncol 30(36):4558–4565

    Article  CAS  PubMed  Google Scholar 

  • Grone J et al (2018) Accuracy of various lymph node staging criteria in rectal cancer with magnetic resonance imaging. J Gastrointest Surg 22(1):146–153

    Article  PubMed  Google Scholar 

  • Habr-Gama A et al (2014) Local recurrence after complete clinical response and watch and wait in rectal cancer after neoadjuvant chemoradiation: impact of salvage therapy on local disease control. Int J Radiat Oncol Biol Phys 88(4):822–828

    Article  PubMed  Google Scholar 

  • Habr-Gama A et al (2017) Organ preservation in cT2N0 rectal cancer after neoadjuvant chemoradiation therapy: the impact of radiation therapy dose-escalation and consolidation chemotherapy. Ann Surg 269(1):102–107

    Article  Google Scholar 

  • Hamaguchi T et al (2011) Final results of randomized trials by the National Surgical Adjuvant Study of Colorectal Cancer (NSAS-CC). Cancer Chemother Pharmacol 67(3):587–596

    Article  CAS  PubMed  Google Scholar 

  • Hasegawa J et al (2014) Neoadjuvant capecitabine and oxaliplatin (XELOX) combined with bevacizumab for high-risk localized rectal cancer. Cancer Chemother Pharmacol 73(5):1079–1087

    Article  CAS  PubMed  Google Scholar 

  • Helbling D et al (2013) Neoadjuvant chemoradiotherapy with or without panitumumab in patients with wild-type KRAS, locally advanced rectal cancer (LARC): a randomized, multicenter, phase II trial SAKK 41/07. Ann Oncol 24(3):718–725

    Article  CAS  PubMed  Google Scholar 

  • Hoerske C et al (2010) Long-term outcomes and quality of life after rectal carcinoma surgery. Br J Surg 97(8):1295–1303

    Article  CAS  PubMed  Google Scholar 

  • Hofheinz RD et al (2012) Chemoradiotherapy with capecitabine versus fluorouracil for locally advanced rectal cancer: a randomised, multicentre, non-inferiority, phase 3 trial. Lancet Oncol 13(6):579–588

    Article  CAS  PubMed  Google Scholar 

  • Hong YS et al (2014) Oxaliplatin, fluorouracil, and leucovorin versus fluorouracil and leucovorin as adjuvant chemotherapy for locally advanced rectal cancer after preoperative chemoradiotherapy (ADORE): an open-label, multicentre, phase 2, randomised controlled trial. Lancet Oncol 15(11):1245–1253

    Article  CAS  PubMed  Google Scholar 

  • Ishii Y et al (2010) Medium-term results of neoadjuvant systemic chemotherapy using irinotecan, 5-fluorouracil, and leucovorin in patients with locally advanced rectal cancer. Eur J Surg Oncol 36(11):1061–1065

    Article  CAS  PubMed  Google Scholar 

  • Kamiya T et al (2016) Early results of multicenter phase II trial of perioperative oxaliplatin and capecitabine without radiotherapy for high-risk rectal cancer: CORONA I study. Eur J Surg Oncol 42(6):829–835

    Article  CAS  PubMed  Google Scholar 

  • Kennecke H et al (2012) Pre-operative bevacizumab, capecitabine, oxaliplatin and radiation among patients with locally advanced or low rectal cancer: a phase II trial. Eur J Cancer 48(1):37–45

    Article  CAS  PubMed  Google Scholar 

  • Kim KH et al (2016) A phase II study of preoperative mFOLFOX6 with short-course radiotherapy in patients with locally advanced rectal cancer and liver-only metastasis. Radiother Oncol 118(2):369–374

    Article  CAS  PubMed  Google Scholar 

  • Kong JC et al (2017) Outcome and salvage surgery following „Watch and Wait“ for rectal cancer after neoadjuvant therapy: a systematic review. Dis Colon Rectum 60(3):335–345

    Article  PubMed  Google Scholar 

  • Landry JC et al (2013) Phase 2 study of preoperative radiation with concurrent capecitabine, oxaliplatin, and bevacizumab followed by surgery and postoperative 5-fluorouracil, leucovorin, oxaliplatin (FOLFOX), and bevacizumab in patients with locally advanced rectal cancer: ECOG 3204. Cancer 119(8):1521–1527

    Article  CAS  PubMed  Google Scholar 

  • Li XT et al (2015) Evaluating local lymph node metastasis with magnetic resonance imaging, endoluminal ultrasound and computed tomography in rectal cancer: a meta-analysis. Colorectal Dis 17(6):O129–135

    Article  PubMed  Google Scholar 

  • Marijnen CA (2015) Organ preservation in rectal cancer: have all questions been answered? Lancet Oncol 16(1):e13–22

    Article  PubMed  Google Scholar 

  • Merkel S et al (2014) Prognostic subdivision of ypT3 rectal tumours according to extension beyond the muscularis propria. Br J Surg 101(5):566–572

    Article  CAS  PubMed  Google Scholar 

  • Mohiuddin M et al (2013) Neoadjuvant chemoradiation for distal rectal cancer: 5-year updated results of a randomized phase 2 study of neoadjuvant combined modality chemoradiation for distal rectal cancer. Int J Radiat Oncol Biol Phys 86(3):523–528

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Nagtegaal ID, Quirke P (2008) What is the role for the circumferential margin in the modern treatment of rectal cancer? J Clin Oncol 26(2):303–312

    Article  PubMed  Google Scholar 

  • Ngan SY et al (2012) Randomized trial of short-course radiotherapy versus long-course chemoradiation comparing rates of local recurrence in patients with T3 rectal cancer: Trans-Tasman Radiation Oncology Group trial 01.04. J Clin Oncol 30(31):3827–3833

    Article  PubMed  Google Scholar 

  • O’Connell MJ et al (2014) Capecitabine and oxaliplatin in the preoperative multimodality treatment of rectal cancer: surgical end points from National Surgical Adjuvant Breast and Bowel Project trial R-04. J Clin Oncol 32(18):1927–1934

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  • Peeters KC et al (2007) The TME trial after a median follow-up of 6 years: increased local control but no survival benefit in irradiated patients with resectable rectal carcinoma. Ann Surg 246(5):693–701

    Article  PubMed  Google Scholar 

  • Petersen SH et al (2012) Postoperative adjuvant chemotherapy in rectal cancer operated for cure. Cochrane Database Syst Rev 3:CD004078

    Google Scholar 

  • Pettersson D et al (2015) Tumour regression in the randomized Stockholm III Trial of radiotherapy regimens for rectal cancer. Br J Surg 102(8):972–978 discussion 978

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Quasar Collaborative G et al (2007) Adjuvant chemotherapy versus observation in patients with colorectal cancer: a randomised study. Lancet 370(9604):2020–2029

    Article  CAS  Google Scholar 

  • Radu C et al (2008) Short-course preoperative radiotherapy with delayed surgery in rectal cancer – a retrospective study. Radiother Oncol 87(3):343–349

    Article  PubMed  Google Scholar 

  • Renehan AG et al (2016) Watch-and-wait approach versus surgical resection after chemoradiotherapy for patients with rectal cancer (the OnCoRe project): a propensity-score matched cohort analysis. Lancet Oncol 17(2):174–183

    Article  PubMed  Google Scholar 

  • Rodel C et al (2015) Oxaliplatin added to fluorouracil-based preoperative chemoradiotherapy and postoperative chemotherapy of locally advanced rectal cancer (the German CAO/ARO/AIO-04 study): final results of the multicentre, open-label, randomised, phase 3 trial. Lancet Oncol 16(8):979–989

    Article  PubMed  CAS  Google Scholar 

  • Roh MS et al (2009) Preoperative multimodality therapy improves disease-free survival in patients with carcinoma of the rectum: NSABP R-03. J Clin Oncol 27(31):5124–5130

    Article  PubMed  PubMed Central  Google Scholar 

  • Ryan JE et al (2016) Predicting pathological complete response to neoadjuvant chemoradiotherapy in locally advanced rectal cancer: a systematic review. Colorectal Dis 18(3):234–246

    Article  CAS  PubMed  Google Scholar 

  • Sainato A et al (2014) No benefit of adjuvant Fluorouracil Leucovorin chemotherapy after neoadjuvant chemoradiotherapy in locally advanced cancer of the rectum (LARC): Long term results of a randomized trial (I-CNR-RT). Radiother Oncol 113(2):223–229

    Article  PubMed  Google Scholar 

  • Sauer R et al (2004) Preoperative versus postoperative chemoradiotherapy for rectal cancer. N Engl J Med 351(17):1731–1740

    Article  CAS  PubMed  Google Scholar 

  • Sauer R et al (2012) Preoperative versus postoperative chemoradiotherapy for locally advanced rectal cancer: results of the German CAO/ARO/AIO-94 randomized phase III trial after a median follow-up of 11 years. J Clin Oncol 30(16):1926–1933

    Article  CAS  PubMed  Google Scholar 

  • Schmoll HJ et al (2014) Effect of adjuvant capecitabine or fluorouracil, with or without oxaliplatin, on survival outcomes in stage III colon cancer and the effect of oxaliplatin on post-relapse survival: a pooled analysis of individual patient data from four randomised controlled trials. Lancet Oncol 15(13):1481–1492

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Schmoll HJ et al (2016) Preoperative chemoradiotherapy and postoperative chemotherapy with capecitabine and oxaliplatin vs. capecitabine alone in locally advanced rectal cancer: final analyses. Annals Oncol 27(6):149–206.

    Article  Google Scholar 

  • Schrag D et al (2014) Neoadjuvant chemotherapy without routine use of radiation therapy for patients with locally advanced rectal cancer: a pilot trial. J Clin Oncol 32(6):513–518

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Shin SJ et al (2011) Upfront systemic chemotherapy and preoperative short-course radiotherapy with delayed surgery for locally advanced rectal cancer with distant metastases. Radiat Oncol 6:99

    Article  PubMed  PubMed Central  Google Scholar 

  • Smith JJ et al (2015) Organ Preservation in Rectal Adenocarcinoma: a phase II randomized controlled trial evaluating 3-year disease-free survival in patients with locally advanced rectal cancer treated with chemoradiation plus induction or consolidation chemotherapy, and total mesorectal excision or nonoperative management. BMC Cancer 15:767

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  • Spigel DR et al (2012) Phase II study of bevacizumab and chemoradiation in the preoperative or adjuvant treatment of patients with stage II/III rectal cancer. Clin Colorectal Cancer 11(1):45–52

    Article  CAS  PubMed  Google Scholar 

  • Taylor FG et al (2011) Preoperative high-resolution magnetic resonance imaging can identify good prognosis stage I, II, and III rectal cancer best managed by surgery alone: a prospective, multicenter, European study. Ann Surg 253(4):711–719

    Article  PubMed  Google Scholar 

  • Uehara K et al (2013) Neoadjuvant oxaliplatin and capecitabine and bevacizumab without radiotherapy for poor-risk rectal cancer: N-SOG 03 Phase II trial. Jpn J Clin Oncol 43(10):964–971

    Article  PubMed  Google Scholar 

  • Valentini V et al (2011) Nomograms for predicting local recurrence, distant metastases, and overall survival for patients with locally advanced rectal cancer on the basis of European randomized clinical trials. J Clin Oncol 29(23):3163–3172

    Article  PubMed  Google Scholar 

  • van der Pool AE et al (2010) Optimizing the outcome of surgery in patients with rectal cancer and synchronous liver metastases. Br J Surg 97(3):383–390

    Article  PubMed  Google Scholar 

  • Van Cutsem E et al (2009) Cetuximab and chemotherapy as initial treatment for metastatic colorectal cancer. N Engl J Med 360(14):1408–1417

    Article  PubMed  Google Scholar 

  • van Dijk TH et al (2013) Evaluation of short-course radiotherapy followed by neoadjuvant bevacizumab, capecitabine, and oxaliplatin and subsequent radical surgical treatment in primary stage IV rectal cancer. Ann Oncol 24(7):1762–1769

    Article  PubMed  Google Scholar 

  • van Gijn W et al (2011) Preoperative radiotherapy combined with total mesorectal excision for resectable rectal cancer: 12-year follow-up of the multicentre, randomised controlled TME trial. Lancet Oncol 12(6):575–582

    Article  PubMed  Google Scholar 

  • Yoon HI et al (2016) Upfront systemic chemotherapy and short-course radiotherapy with delayed surgery for locally advanced rectal cancer with distant metastases: outcomes, compliance, and favorable prognostic factors. PLoS ONE 11(8):e0161475

    Article  PubMed  PubMed Central  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Medizinische Klinik III mit Schwerpunkt Hämatologie, Onkologie und Tumorimmunologie, CharitéCentrum Tumormedizin, Charité Universitätsmedizin Berlin, Berlin, Deutschland

    Antonia Busse

Authors
  1. Antonia Busse
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Antonia Busse .

Editor information

Editors and Affiliations

  1. Klinik für Allgemein-, Viszeral- und Gefäßchirurgie, Campus Benjamin Franklin, Charite – Universitätsmedizin Berlin, Berlin, Germany

    Martin E. Kreis

  2. Klinik für Radiologie Campus Benjamin Franklin, Charité – Universitätsmedizin Berlin, Berlin, Germany

    Patrick Asbach

Rights and permissions

Reprints and permissions

Copyright information

© 2020 Springer-Verlag GmbH Deutschland, ein Teil von Springer Nature

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Busse, A. (2020). Optionen der neoadjuvanten Therapie beim Rektumkarzinom. In: Kreis, M., Asbach, P. (eds) MRT-basierte Chirurgie des Rektumkarzinoms. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-58159-9_7

Download citation

  • DOI: https://doi.org/10.1007/978-3-662-58159-9_7

  • Published:

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-58158-2

  • Online ISBN: 978-3-662-58159-9

  • eBook Packages: Medicine (German Language)

Publish with us

Policies and ethics

Search

Navigation