Department of Digestive and Oncologic Surgery, AP-HP, Hôpital Ambroise Paré, Université Versailles Saint Quentin en Yvelines, Versailles, France.
Dig Dis. 2012;30 Suppl 2:132-6. doi: 10.1159/000342043. Epub 2012 Nov 23.
Synchronous colorectal liver metastases include a wide variety of clinical presentation depending on the location and the extent of the primary tumor, the extent of metastatic disease in the liver, and the presence of extrahepatic disease. Only a minority of patients with synchronous colorectal liver metastases and an intact primary tumor can be candidates for a curative treatment approach. In the past two decades, considerable progress with both antitumor agents and surgical strategies has contributed to increase the number of patients that can achieve complete resection of primary tumor and liver metastases. Optimal treatment of colorectal resectable liver metastases includes preoperative chemotherapy that can be administered after resection of the primary tumor and before resection of liver metastases in a 'classical' fashion, before combined resection of the primary tumor and liver metastases, and before liver resection of liver metastases followed by resection of the primary tumor in the reverse strategy. With regard to the large variety of clinical presentations in patients with synchronous colorectal liver metastases, none of these treatment strategies can be recommended in all patients. The complexity and the multiplicity of available treatment options underline the need for a multidisciplinary approach to this disease.
同步结直肠肝转移包括广泛的临床表现，取决于原发肿瘤的位置和范围、肝转移的程度以及肝外疾病的存在。只有少数同步结直肠肝转移且原发肿瘤完整的患者可以成为根治性治疗方法的候选者。在过去的二十年中，抗肿瘤药物和手术策略的显著进展有助于增加能够完全切除原发肿瘤和肝转移的患者数量。结直肠可切除肝转移的最佳治疗包括术前化疗，可以在切除原发肿瘤后、在“经典”方式切除肝转移前、联合切除原发肿瘤和肝转移前以及肝转移肝切除后、然后在反转策略中切除原发肿瘤时进行。鉴于同步结直肠肝转移患者临床表现的多样性，这些治疗策略都不能推荐给所有患者。可供选择的治疗方案的复杂性和多样性突出了需要对这种疾病采取多学科的方法。
