伴有肝外疾病的结直肠癌肝转移——肿瘤切除的新标准？
Colorectal liver metastases with extrahepatic disease--a new criteria for oncologic resection?
作者信息
Chua Terence C, Morris David L
机构信息
Hepatobiliary and Surgical Oncology Unit, UNSW Department of Surgery, St George Hospital and St George Clinical School, University of New South Wales, Kogarah, Sydney, NSW, 2217, Australia.
出版信息
J Gastrointest Cancer. 2012 Sep;43(3):502-4. doi: 10.1007/s12029-011-9278-9.
BACKGROUND
Emerging data suggest that in the current era of modern systemic therapies, resection of colorectal liver metastases with concomitant extrahepatic disease may be a curative option in selected patients.
METHODS
A commentary of several key recent papers including an international multi-institutional registry study may provide directions in the future management of this disease entity.
RESULTS
The premise of selecting patients for a surgical approach to resect colorectal liver metastases and concomitant extrahepatic disease should be individualized. Incorporation of key prognostic factors that include the site of extrahepatic disease, the ability to undertake a complete resection, disease responding to chemotherapy, and an assessment of tumor biology through examining an individual's disease history may guide the selection of suitable patients for this therapeutic pursuit. A 5-year survival of 30% may be realized in well-selected patients.
CONCLUSION
Concomitant extrahepatic disease in patients with colorectal liver metastases should not be a contraindication to resection of colorectal cancer metastases.
背景
新出现的数据表明，在当前现代全身治疗时代，对于部分患者，切除伴有肝外疾病的结直肠癌肝转移灶可能是一种治愈性选择。
方法
对几篇近期关键论文（包括一项国际多机构注册研究）的评论可能为该疾病实体的未来管理提供指导。
结果
选择手术切除结直肠癌肝转移灶及伴发肝外疾病患者的前提应个体化。纳入关键预后因素，包括肝外疾病部位、完整切除的能力、对化疗有反应的疾病，以及通过检查个体疾病史评估肿瘤生物学特性，可能有助于指导选择适合这种治疗方法的患者。精心挑选的患者5年生存率可达30%。
结论
结直肠癌肝转移患者伴发肝外疾病不应成为切除结直肠癌转移灶的禁忌证。
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