Department of medical oncology, Regional cancer center, Hassan II Hospital, Agadir-80000, Morocco.
World J Surg Oncol. 2011 Nov 24;9:154. doi: 10.1186/1477-7819-9-154.
Colorectal cancer (CRC) is the third most common cancer in the word. Liver metastasis is the most common site of colorectal metastases. The prognosis of resectable colorectal liver metastases (CRLM) was improved in the recent years with the consideration of chemotherapy and surgical resection as part of the multidisciplinary management of the disease; the current 5-year survival rates after resection of liver metastases are 25% to 40%. Resectable synchronous or metachronous liver metastases should be treated with perioperative chemotherapy based on three months of FOLFOX4 (5-fluorouracil [5FU], folinic acid [LV], and oxaliplatin) chemotherapy before surgery and three months after surgery. In the case of primary surgery, pseudo-adjuvant chemotherapy for 6 months, based on 5FU/LV, FOLFOX4, XELOX (capecitabine and oxaliplatin) or FOLFIRI (5FU/LV and irinotecan), should be indicated. In potentially resectable disease, primary chemotherapy based on more intensive regimens such as FOLFIRINOX (5FU/LV, irinotecan and oxaliplatin) should be considered to enhance the chance of cure. The palliative chemotherapy based on FOLFIRI, or FOLFOX4/XELOX with or without targeted therapies, is the mainstay treatment of unresectable disease. This review would provide additional insight into the problem of optimal integration of chemotherapy and surgery in the management of CRLM.
结直肠癌（CRC）是世界上第三大常见癌症。肝转移是结直肠转移的最常见部位。随着化疗和手术切除被视为疾病多学科管理的一部分，可切除结直肠肝转移（CRLM）的预后在近年来得到改善；手术后肝转移的 5 年生存率为 25%至 40%。可切除的同步或异时性肝转移应在术前和术后三个月内接受基于 FOLFOX4（氟尿嘧啶[5FU]、亚叶酸[LV]和奥沙利铂）化疗的围手术期化疗。在原发性手术的情况下，应基于 5FU/LV、FOLFOX4、XELOX（卡培他滨和奥沙利铂）或 FOLFIRI（5FU/LV 和伊立替康）进行 6 个月的假性辅助化疗。在潜在可切除疾病中，应考虑基于更强化疗方案（如 FOLFIRINOX（5FU/LV、伊立替康和奥沙利铂）的原发性化疗，以提高治愈的机会。基于 FOLFIRI 或 FOLFOX4/XELOX 联合或不联合靶向治疗的姑息化疗是不可切除疾病的主要治疗方法。本综述将为化疗和手术在 CRLM 管理中的最佳整合问题提供更多的见解。
