Bergenfeldt Magnus, Jensen Benny Vittrup
Herlev Hospital, Afdelingen for Kirurgisk Gastroenterologi, Herlev.
Ugeskr Laeger. 2008 Apr 14;170(16):1353-6.
Isolated colorectal liver metastases should be referred for multispecialist management at a liver centre. Long-time survival is possible after resection and adjuvant therapy. If unresectable, newer chemotherapy with oxaliplatin, irinitecan, bevacizumab and cetuximab may result in a median survival > 20 months. Selected patients may be down-staged and resected with good long-time survival. Bilateral, multiple and large metastases can also be treated by complex combinations of portal vein embolization/ligature, staged resections and local (radiofrequency) ablation.
孤立性结直肠癌肝转移应转至肝脏中心进行多专科管理。切除及辅助治疗后有可能实现长期生存。若无法切除,使用奥沙利铂、伊立替康、贝伐单抗和西妥昔单抗的新型化疗可能使中位生存期>20个月。部分患者可能降期并接受切除,从而获得良好的长期生存。双侧、多发及较大的转移灶也可通过门静脉栓塞/结扎、分期切除及局部(射频)消融等综合治疗手段进行处理。