Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai 200032, China.
World J Gastroenterol. 2012 Jan 7;18(1):25-33. doi: 10.3748/wjg.v18.i1.25.
Surgical resection of liver metastases of colorectal cancer greatly improves the clinical outcome of patients with advanced disease. Developments in chemotherapeutic agents and strategies bring hope of a cure to patients with initially unresectable colorectal liver metastases (CLM). Perioperative chemotherapy significantly improves the survival time of patients who receive curative-intent hepatectomy. Even for unresectable CLM, recent studies demonstrated that active preoperative chemotherapy could achieve shrinkage of liver metastasis and thus render some for resection. Furthermore, an increase in tumor resection rate and prolonged survival time among patients with CLM has been observed following the application of monoclonal antibodies in recent years. However, the value of chemotherapy via hepatic arterial infusion is still unclear. More trials should be conducted in patients with CLM in order to improve survival.
结直肠癌肝转移的外科切除极大地改善了晚期患者的临床预后。化疗药物和策略的发展为最初不可切除的结直肠肝转移(CLM)患者带来了治愈的希望。围手术期化疗显著改善了接受根治性肝切除术患者的生存时间。即使对于不可切除的 CLM,最近的研究表明,积极的术前化疗可以使肝转移缩小,从而使部分患者获得切除的机会。此外,近年来单克隆抗体的应用观察到 CLM 患者的肿瘤切除率增加和生存时间延长。然而,肝动脉灌注化疗的价值仍不清楚。为了提高生存率,应该在 CLM 患者中进行更多的临床试验。