Mohammad Waleed M, Balaa Fady K
Liver and Pancreas Unit, The Ottawa Hospital, University of Ottawa, Ottawa, Ontario, Canada.
Clin Colon Rectal Surg. 2009 Nov;22(4):225-32. doi: 10.1055/s-0029-1242462.
Colorectal cancer is the third most commonly diagnosed cancer with approximately half of the patients developing liver metastases during the course of their disease. Modern multimodal therapies have improved the overall survival. Liver resection remains the most important modality in the treatment of colorectal liver metastases. The evolution of the criteria for resectability has resulted in more patients being offered a hepatectomy. This is further augmented with the utilization of adjuncts to liver resection, including portal vein embolization and local ablative techniques. Two-stage hepatectomy is also being used to increase resectability. Overall survival is improved by the deployment of new chemotherapeutic agents and the use of combination chemotherapy. Neoadjuvant chemotherapy is a promising development in the treatment of colorectal liver metastases. Patients with colorectal liver metastases can achieve long-term survival. A multidisciplinary approach is essential in the management of these patients.
结直肠癌是第三大常见诊断癌症，约有一半患者在病程中会发生肝转移。现代多模式疗法已改善了总体生存率。肝切除术仍然是治疗结直肠癌肝转移的最重要方式。可切除性标准的演变使得更多患者能够接受肝切除术。肝切除辅助手段的应用进一步增加了可切除性，这些辅助手段包括门静脉栓塞和局部消融技术。两阶段肝切除术也被用于提高可切除性。新型化疗药物的应用和联合化疗的使用改善了总体生存率。新辅助化疗是结直肠癌肝转移治疗中一个有前景的进展。结直肠癌肝转移患者能够实现长期生存。多学科方法对于这些患者的管理至关重要。
