Ruo L, DeMatteo R P, Blumgart L H
Department of Surgery, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10021, USA.
Clin Colorectal Cancer. 2001 Nov;1(3):154-66; discussion 167-8. doi: 10.3816/ccc.2001.n.016.
Intrahepatic recurrence is common after major resection for colorectal cancer (CRC) metastases to the liver. In this review, the available data on different adjuvant therapies from systemic chemotherapy to regional approaches by direct perfusion of chemotherapeutic agents via the hepatic artery and portal vein will be discussed. Intraperitoneal administration of chemotherapy is another form of regional therapy. Novel approaches with immunotherapy and trials of neoadjuvant therapy in association with resection of CRC hepatic metastases have also been reported. The purpose of this review is to outline these various strategies and their role in combination with resection of CRC liver metastases. Although improved hepatic disease-free survival has been demonstrated with some strategies, overall survival is minimally affected and recurrence of metastatic disease at distant sites is still a major problem. Therefore, future directions should incorporate the use of new systemic agents effective against CRC metastases. Identification of subgroups through clinical features, molecular markers, proteins, or specific tumor properties may also help to individualize treatment.
结直肠癌（CRC）肝转移灶进行大切除术后，肝内复发很常见。在这篇综述中，我们将讨论从全身化疗到通过肝动脉和门静脉直接灌注化疗药物的区域治疗等不同辅助治疗的现有数据。腹腔内化疗是区域治疗的另一种形式。也有报道称采用了免疫疗法的新方法以及新辅助治疗联合切除CRC肝转移灶的试验。这篇综述的目的是概述这些不同的策略及其在联合切除CRC肝转移灶中的作用。尽管一些策略已证明可改善无肝病生存期，但总体生存期受影响极小，远处转移疾病的复发仍是一个主要问题。因此，未来的方向应包括使用对CRC转移有效的新型全身药物。通过临床特征、分子标志物、蛋白质或特定肿瘤特性来识别亚组，也可能有助于实现个体化治疗。
