Brouquet Antoine, Nordlinger Bernard
Department Digestive and Oncologic Surgery, AP-HP, Université Versailles Saint Quentin en Yvelines, Hôpital Ambroise Paré, Versailles, France.
Scand J Gastroenterol. 2012 Mar;47(3):286-95. doi: 10.3109/00365521.2012.640826. Epub 2011 Dec 19.
Liver resection is associated with prolonged survival in patients with colorectal liver metastases. At diagnosis, 15-20% of patients have resectable colorectal liver metastases whereas other patients have too advanced disease to enable surgical treatment and receive chemotherapy. In patients undergoing resection of colorectal liver metastases, disease relapse occurs in up to 70%. Therefore, a combined approach including preoperative or postoperative chemotherapy or both has been tested to improve outcome after surgery. In patients with unresectable colorectal liver metastases, chemotherapy is initially the sole treatment option. The considerable improvement of the efficacy of anticancer agents has contributed to increase the response rate in patients with advanced colorectal cancer. In case of major response to chemotherapy, surgery with curative intent can be offered to patients with initially unresectable liver metastases.
肝切除与结直肠癌肝转移患者的生存期延长相关。在诊断时，15%至20%的患者有可切除的结直肠癌肝转移，而其他患者疾病进展过于严重，无法进行手术治疗，只能接受化疗。在接受结直肠癌肝转移切除术的患者中，高达70%会出现疾病复发。因此，已对包括术前或术后化疗或两者兼用的联合治疗方法进行了测试，以改善手术后的疗效。对于不可切除的结直肠癌肝转移患者，化疗最初是唯一的治疗选择。抗癌药物疗效的显著提高有助于提高晚期结直肠癌患者的缓解率。对于化疗有显著反应的患者，对于最初不可切除的肝转移患者可以提供根治性手术。
