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结直肠孤立性肝转移的处理。

The management of solitary colorectal liver metastases.

机构信息

Department of Surgical Oncology, The University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 444, Houston, TX 77030, United States.

出版信息

Surgeon. 2011 Oct;9(5):265-72. doi: 10.1016/j.surge.2010.12.005. Epub 2011 Feb 3.

Abstract

Surgical resection of solitary colorectal liver metastases is associated with long-term survival. Radiofrequency ablation used as the primary treatment option of solitary resectable colorectal liver metastases is associated with an increased risk of local recurrence that generally leads to worse survival compared to resection. In contrast with treatment of other hepatic malignancies, radiofrequency ablation is not equivalent to resection for colorectal liver metastases and should not be used as an alternative but limited to inoperable patients. Although overall survival rate after resection can be up to 71% at 5 years, the majority of patients develop recurrence. Preoperative chemotherapy contributes to decrease the risk of recurrence after resection of colorectal liver metastases. In patients with advanced solitary colorectal liver metastasis initially non suitable for resection, chemotherapy and portal vein embolization contribute to increase the number of surgical candidates whereas radiofrequency is rarely an option.

摘要

结直肠单发肝转移瘤行外科切除可获得长期生存。射频消融作为单发可切除结直肠肝转移瘤的首选治疗方法,与局部复发风险增加相关,与切除相比,通常导致生存状况更差。与其他肝脏恶性肿瘤的治疗不同,射频消融与结直肠肝转移瘤的切除不等效,不应该作为一种替代方法,而仅限于不能手术的患者。虽然切除后 5 年的总生存率可高达 71%,但大多数患者会复发。术前化疗有助于降低结直肠肝转移瘤切除后复发的风险。对于最初不适合切除的进展期单发结直肠肝转移瘤患者,化疗和门静脉栓塞有助于增加手术候选者的数量,而射频消融很少是一种选择。

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