Andreou Andreas, Aloia Thomas A, Brouquet Antoine, Vauthey Jean-Nicolas
Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX.
Gastrointest Cancer Res. 2011 Jul;4(4 Suppl 1):S2-8.
Liver resection provides the basis for curative treatment of colorectal liver metastases (CLM), achieving 5-year survival rates as high as 58%. Use of this approach is limited by the number of patients whose CLM are resectable at the time of initial presentation and the risk of early recurrence after surgery, justifying development of modern perioperative chemotherapy regimens. Chemotherapy-associated hepatotoxicity led to development of standardized treatment strategies that balance the duration and timing of preoperative chemotherapy to minimize postoperative morbidity. The current challenge in the effort to offer curative treatment for CLM is selection of patients who will most benefit from an aggressive surgical approach. New end points of preoperative chemotherapy such as pathologic response and new radiologic response criteria have been evaluated as predictive factors for survival after liver resection and provide useful support in selecting patients for surgery.
肝切除为结直肠癌肝转移（CLM）的根治性治疗提供了基础，5年生存率高达58%。这种方法的应用受到初次就诊时可切除CLM患者数量以及术后早期复发风险的限制，这也促使了现代围手术期化疗方案的发展。化疗相关的肝毒性导致了标准化治疗策略的制定，该策略平衡了术前化疗的持续时间和时机，以尽量减少术后发病率。目前在为CLM提供根治性治疗方面面临的挑战是选择最能从积极手术方法中获益的患者。术前化疗的新终点，如病理反应和新的放射学反应标准，已被评估为肝切除术后生存的预测因素，并为选择手术患者提供了有用的支持。
