Penna Christophe, Nordlinger Bernard
Division of Digestive and Oncologic Surgery, Ambroise Paré Hospital and University of Paris V, 9 avenue Charles-de-Gaulle, 92104 Boulogne Cedex, France.
Surg Clin North Am. 2002 Oct;82(5):1075-90, x-xi. doi: 10.1016/s0039-6109(02)00051-8.
Distant metastases are the major cause of death for colorectal carcinoma patients. Depending on the primary tumor's stage, liver metastases occur in 20% to 70% of patients and lung metastases in 10% to 20%. Unlike many other cancers, the presence of distant metastases from colorectal cancer does not preclude curative treatment. Surgical resection remains the only treatment that can ensure long-term survival and cure in some patients, but only a minority of liver metastases are amenable to surgery. New treatment modalities including portal vein embolization, perioperative chemotherapy and local destruction with cryotherapy or radiofrequency ablation may make more patients suitable for surgical resection of hepatic metastases and may prolong survival in cases of nonresectabilitv. The availability of new active drugs has changed the treatment of liver metastases from colorectal cancer.
远处转移是结直肠癌患者死亡的主要原因。根据原发肿瘤的分期,20%至70%的患者会发生肝转移,10%至20%的患者会发生肺转移。与许多其他癌症不同,结直肠癌出现远处转移并不排除进行根治性治疗。手术切除仍然是唯一能够确保部分患者长期生存和治愈的治疗方法,但只有少数肝转移患者适合手术。包括门静脉栓塞、围手术期化疗以及冷冻疗法或射频消融局部破坏等新的治疗方式,可能会使更多患者适合肝转移灶的手术切除,并在无法切除的情况下延长生存期。新型活性药物的出现改变了结直肠癌肝转移的治疗方式。