Lise M, Pilati P, Da Pian P, Mocellin S, Nitti D, Corazzino S
Surgery Branch, Department of Oncological and Surgical Sciences, University of Padova, Padova, Italy.
J Exp Clin Cancer Res. 2003 Dec;22(4 Suppl):149-56.
The liver is the most common site of distant metastasis from colorectal cancer. About one-fourth of patients with liver metastases from colorectal cancer have no other sites of metastasis. Surgical resection of colorectal cancer liver metastases can result in a 24%-38% five-year survival. However, only a minority of patients are candidates for resection and no adjuvant treatment has been demonstrated to be effective in increasing the survival rate following radical surgery. For unresectable disease, several treatments have been tested in the clinical setting, although none of them can be currently considered a standard approach. Systemic chemotherapy is not generally considered a treatment for cure, although newer regimens appear to improve median survival. Locoregional therapies such hepatic intra-arterial chemotherapy and isolated hepatic perfusion may be offered to patients with unresectable liver metastases in the absence of extra-hepatic disease. However, the efficacy of these treatments is still being determined. Both systemic and locoregional chemotherapy might be useful in the neoadjuvant setting to increase the resectability of liver metastases initially not amenable to surgical resection.
肝脏是结直肠癌远处转移最常见的部位。约四分之一的结直肠癌肝转移患者没有其他转移部位。结直肠癌肝转移的手术切除可使五年生存率达到24% - 38%。然而，只有少数患者适合手术切除，且尚无辅助治疗被证明能有效提高根治性手术后的生存率。对于不可切除的疾病，临床上已经对几种治疗方法进行了测试，但目前没有一种可被视为标准方法。全身化疗一般不被认为是一种治愈性治疗方法，尽管新的治疗方案似乎能改善中位生存期。对于没有肝外疾病的不可切除肝转移患者，可采用肝动脉内化疗和孤立肝灌注等局部区域治疗方法。然而，这些治疗方法的疗效仍在确定中。全身化疗和局部区域化疗在新辅助治疗中可能都有助于提高最初无法进行手术切除的肝转移灶的可切除性。
