Chiappa A, Makuuchi M, Lygidakis N J, Zbar A P, Chong G, Bertani E, Sitzler P J, Biffi R, Pace U, Bianchi P P, Contino G, Misitano P, Orsi F, Travaini L, Trifirò G, Zampino M G, Fazio N, Goldhirsch A, Andreoni B
Department of General Surgery-Laparoscopic Surgery, University of Milano, European Institute of Oncology, Milano, Italy.
Crit Rev Oncol Hematol. 2009 Oct;72(1):65-75. doi: 10.1016/j.critrevonc.2008.11.003. Epub 2009 Jan 14.
Colorectal cancer (CRC) caused nearly 204,000 deaths in Europe in 2004. Despite recent advances in the treatment of advanced disease, which include the incorporation of two new cytotoxic agents irinotecan and oxaliplatin into first-line regimens, the concept of planned sequential therapy involving three active agents during the course of a patient's treatment and the integrated use of targeted monoclonal antibodies, the 5-year survival rates for patients with advanced CRC remain unacceptably low. For patients with colorectal liver metastases, liver resection offers the only potential for cure. This review, based on the outcomes of a meeting of European experts (surgeons and medical oncologists), considers the current treatment strategies available to patients with CRC liver metastases, the criteria for the selection of those patients most likely to benefit and suggests where future progress may occur.
2004年，结直肠癌（CRC）在欧洲导致近20.4万人死亡。尽管晚期疾病的治疗取得了最新进展，包括将两种新型细胞毒性药物伊立替康和奥沙利铂纳入一线治疗方案、在患者治疗过程中采用包含三种活性药物的计划性序贯治疗概念以及靶向单克隆抗体的综合应用，但晚期结直肠癌患者的5年生存率仍然低得令人难以接受。对于结直肠癌肝转移患者，肝切除是唯一可能治愈的方法。本综述基于欧洲专家（外科医生和医学肿瘤学家）会议的结果，探讨了目前可用于结直肠癌肝转移患者的治疗策略、选择最可能受益患者的标准，并指出未来可能取得进展的方向。
