All efforts of multimodal therapy must be applied with strict indications to improve the outcome of the surgical treatment.
Professor Link and his team were among the first to propagate multimodal therapy of colon- and rectal primary tumors and metastases in Germany and worldwide and thus improved the survival rates by more than 20% e.g. in stage III colon cancer.
This treatment concept now has become part in many national S3-Guide Lines. The Ulm based research team together with their interdisciplinary nationwide „Forschungsgruppe Onkologie Gastrointestinale Tumoren (FOGT, 64 hospitals), inaugurated (Surgery: Prof. K. H. Link; Medical Oncology: Prof. E. D. Kreuser; Radiation Oncology: Prof. E. Röttinger, Biometry: Prof. W. Gaus.) to improve the surgical outcome in colon- and rectal cancer by additional „multimodal treatment“ (surgery, chemotherapy, radiotherapy etc.) (FOGT 1 Colon Cancer, FOGT 2 Rectal Cancer), by translational research including treatment individualization. Surgery, multimodal treatment, and oncological results were improved significantly.
The Ulm Team with the FOGT has also made very innovative and outstanding contributions to „treatment individualization“ even 20 years before this topic has now become the main issue of up to date oncology. The Ulm Team, on the contrary, also warned to apply overtreatment. At APK/ATC interdisciplinary structures and groups have been constituted to treat each patient with the optimal treatment concept.
Merits: Publication in the world´s best surgical scientific journal, „Annals of Surgery“ (Multimodal Therapy of Colon Cancer, FOGT-1), rating as „Best Paper of the Year 2000“ in one of the most prestigious cancer journals, „Cancer“ (Treatment Individualization in Chemotherapy of Liver Metastases).
Surgery and multimodal therapy in colon- and in rectal cancers: Training of procedures and developments of multimodal treatment (FOGT 1+2 trials).
Personally and within the Team and FOGT/ICRCC, surgery of colon- and of rectal cancer has been continously optimized in exchange with the world´s top surgical oncologists. Definitions of optimal surgery in publications and scientific presentations by Professor Link nationally/internationally.
Optimal surgery and multimodal therapy
Apply most modern surgical technique (Mesocolic excision).
Laparoscopic technique does not improve survival; the exploration of the abdomen cannot be performed as secure as in open surgery. Laparoscopic sigmoid resection at APK is standard for diverticulitis surgery. Laparoscopic colon cancer resection may be offered to certain patients.
Provide adjuvant chemotherapy, if indicated.
K. H. Link, M. Hauser, M. Mann, P. M. Schlag: Kolonkarzinom
Chirurgische Onkologie Strategien und Standards für die Praxis
Michael Gnant, Peter M. Schlag (Hrsg.), Kapitel 23, 315-329, Springer Wien/New York, 2008
K. H. Link, T.A. Sagban, M. Moerschel, K. Tischbirek, M. Holtappels, V. Apell, K. Zayed, M. Kornmann, L. Staib
Colon cancer: survival after curative surgery, Langenbeck´s Archives of Surgery, 390, 83-93, 2005