Nordlinger Bernard, Benoist Stéphane
Service de Chirurgie Générale Digestive et Oncologique, Hôpital Ambroise Paré, 9 avenue Charles de Gaulle-92104 Boulogne.
Bull Acad Natl Med. 2003;187(5):899-904.
For a long time, patients with liver metastases from colorectal cancer were considered to be incurable. Over the last 30 years, the benefits of surgical resection and systemic chemotherapy have been established. To date, surgical resection remains the only treatment that can ensure long-term survival and cure in some patient. However, only a minority of patients with liver metastases are amenable to surgery and after resection of liver metastases, recurrences are still observed in two third of patients. Therefore, efforts have been made to increase the number of patients that could be candidates for surgery and to decrease the risk of recurrence after surgical resection. Shrinkage of tumours after administration of pre-operative chemotherapy and the availability of new surgical technique, including portal vein embolization, cryotherapy and radiofrequency ablation, now allows the treatment, with curative intent, of metastases initially considered as non-resectable. Chemotherapy regimens have been developed to decrease the risk of postoperative recurrence.
长期以来，结直肠癌肝转移患者一直被认为无法治愈。在过去30年里，手术切除和全身化疗的益处已得到证实。迄今为止，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。然而，只有少数肝转移患者适合手术，并且在肝转移灶切除后，仍有三分之二的患者会出现复发。因此，人们一直在努力增加适合手术的患者数量，并降低手术切除后的复发风险。术前化疗后肿瘤缩小以及新手术技术的出现，包括门静脉栓塞、冷冻疗法和射频消融，现在使得最初被认为不可切除的转移灶能够以治愈为目的进行治疗。已经开发出化疗方案以降低术后复发风险。
