Adam René, Vibert Eric, Pitombo Marcos
Centre hépatobiliaire, Hôpital Paul Brousse, Université de Paris-Sud, 12, avenue Paul-Vaillant-Couturier, 94804 Villejuif Cedex.
Bull Cancer. 2006 Feb 1;93 Suppl 1:S45-9.
Surgery is the only curative treatment for patients with colorectal liver metastases with recent reports documenting 5-year survival results of 40-50%. In unresectable patients, the use of more effective regimens of chemotherapy has contributed to improve the results of survival at short term and new onco-surgical strategies have emerged. By allowing resection of previously unresectable liver metastases, these onco-surgical strategies now offer 15-20% of patients a real potential of long-term remission (5-year survival 30-40%). Chemotherapy is also used in the adjuvant setting, to prevent post-operative recurrence. In resectable metastases, it may also be used as neo-adjuvant treatment to control tumor progression before surgery and to select the patients likely to really benefit from liver resection. The objective of this article is to describe this multidisciplinary approach of liver metastases and to report the results of these new strategies.
手术是结直肠癌肝转移患者唯一的治愈性治疗方法,最近的报告显示其5年生存率为40%-50%。对于无法切除的患者,使用更有效的化疗方案有助于提高短期生存结果,并且出现了新的肿瘤外科策略。通过允许切除以前无法切除的肝转移灶,这些肿瘤外科策略现在为15%-20%的患者提供了长期缓解的真正潜力(5年生存率30%-40%)。化疗也用于辅助治疗,以防止术后复发。在可切除的转移灶中,它也可作为新辅助治疗,在手术前控制肿瘤进展,并选择可能真正从肝切除术中获益的患者。本文的目的是描述这种肝转移的多学科治疗方法,并报告这些新策略的结果。