Adam René
Hôpital Paul Brousse, Assistance Publique-Hopitaux de Paris, University Paris Sud 11, 14 Avenue Paul Vaillant Couturier, 94800 Villejuif, Paris, France.
Semin Oncol. 2007 Apr;34(2 Suppl 1):S7-11. doi: 10.1053/j.seminoncol.2007.01.003.
Five-year survival rates of patients with liver metastases from colorectal cancer range from 30% to 40% for those who undergo successful resection procedures, and is almost nil among those unable to have surgery. However, improved chemotherapy strategies for nonoperable patients (specifically, the use of neoadjuvant oxaliplatin- and irinotecan-based regimens) have increased response rates and tumor downstaging such that 15% to 30% of initially nonoperable patients are able to have secondary, or rescue, surgery. Preliminary data also indicate that new targeted therapies should further increase response rates and thus resection rates. Operative techniques such as portal vein embolization and two-stage procedures for patients with multiple or large tumors, as well as use of cryosurgery and radiofrequency ablation, are also contributing to more effective removal of liver metastases from colorectal cancer. This brief report describes data supporting the expanding application of hepatectomy for patients with colorectal liver metastases.
结直肠癌肝转移患者中，成功接受切除手术者的五年生存率为30%至40%，而无法进行手术者的五年生存率几乎为零。然而，针对无法手术患者的化疗策略有所改进（具体而言，使用以奥沙利铂和伊立替康为基础的新辅助治疗方案），提高了缓解率并使肿瘤降期，从而使15%至30%最初无法手术的患者能够接受二期手术或挽救性手术。初步数据还表明，新的靶向治疗应能进一步提高缓解率，进而提高切除率。诸如门静脉栓塞等手术技术以及针对多发或巨大肿瘤患者的两阶段手术，还有冷冻手术和射频消融的应用，也有助于更有效地切除结直肠癌的肝转移灶。本简要报告描述了支持扩大肝切除术在结直肠癌肝转移患者中应用的数据。
