Brouquet A, Mitry E, Benoist S
Service de Chirurgie Digestive et Oncologique AP-HP, Hôpital Ambroise Paré, 9, avenue Charles-de-Gaulle, 92104 Boulogne cedex, France; Université de Versailles - Saint-Quentin-en-Yvelines, 23, rue du Refuge, 78000 Versailles, France.
J Chir (Paris). 2010 Jan;147 Suppl 1:S1-6. doi: 10.1016/S0021-7697(10)70001-6.
Surgical resection remains the only treatment of colorectal liver metastases that can ensure long-term survival and cure in some patients, but only a minority of patients with liver metastases is directly amenable to surgery. Cancer relapse is observed in the majority of patients after resection of liver metastases despite progress in surgical technique and improved surgical skills. In order to decrease the risk of cancer relapse, it has been proposed to combine surgery and chemotherapy, which could be administered before, after or before and after surgery. It has been demonstrated that perioperative chemotherapy can reduce the risk of cancer relapse and should be considered as the standard of care for most patients with resectable colorectal liver metastases. However perioperative chemotherapy has also potential disadvantages. This review will summarize the current data on the rationale, benefits and potential disadvantages of perioperative chemotherapy in patients with resectable colorectal liver metastases.
手术切除仍然是结直肠癌肝转移唯一能确保部分患者长期生存和治愈的治疗方法，但只有少数肝转移患者可直接接受手术。尽管手术技术取得了进展且手术技巧有所提高，但大多数患者在肝转移灶切除术后仍会出现癌症复发。为了降低癌症复发风险，有人提出将手术与化疗相结合，化疗可在手术前、手术后或手术前后进行。已经证明围手术期化疗可以降低癌症复发风险，应被视为大多数可切除结直肠癌肝转移患者的标准治疗方案。然而，围手术期化疗也有潜在的缺点。本综述将总结目前关于可切除结直肠癌肝转移患者围手术期化疗的理论依据、益处和潜在缺点的数据。
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