Fondazione IRCCS Policlinico San Matteo, and University of Pavia, Viale Camillo Golgi 19, Pavia 27100PV, Italy.
World J Surg Oncol. 2013 Aug 13;11(1):192. doi: 10.1186/1477-7819-11-192.
Liver resection is the mainstay of treatment for patients with primary and metastatic liver tumors. However, a large majority of patients present for initial medical evaluation with primary and metastatic liver tumors when their cancer is unresectable. Several trials have been undertaken to identify alternative treatments and complementary therapies. In the near future, the field of liver surgery will aim to increase the number of patients that can benefit from resection, since radical removal of the tumor currently provides the sole chance of cure. This paper reports the case of a patient with an advanced colonic cancer in the era of stem cell therapy. In 2011, a 57 years old white Caucasian man with a previous history of non-Hodgkin lymphoma (NHL) was diagnosed with colon cancer and bilobar liver metastases. Following neoadjuvant therapy, the patient was enrolled in a protocol of stem cell administration for liver regeneration. Surgery was initially performed on the primary cancer and left liver lobe. An extended right lobectomy to S1 was then performed after a portal vein embolization (PVE) and stem cell stimulation of the remaining liver. The postoperative course was uneventful and the patient was free of disease after 12 months. Extreme liver resection can provide a safer option and a chance of cure to otherwise unresectable patients when liver regeneration is boosted by PVE and stem cell administration.
肝切除术是治疗原发性和转移性肝肿瘤患者的主要方法。然而,大多数患者在初次就诊时就已经被诊断为不可切除的原发性和转移性肝肿瘤。已经进行了几项试验来确定替代治疗和补充疗法。在不久的将来,肝外科领域的目标是增加可以从肝切除中受益的患者数量,因为目前根治性切除肿瘤是唯一的治愈机会。本文报告了一名接受干细胞治疗的晚期结肠癌患者的病例。2011 年,一名 57 岁白人男性,有非霍奇金淋巴瘤(NHL)病史,被诊断为结肠癌和双叶肝转移。在新辅助治疗后,该患者被纳入一项用于肝再生的干细胞给药方案。最初对原发性癌症和左肝叶进行手术。然后,在门静脉栓塞术(PVE)和剩余肝脏的干细胞刺激后,进行了扩大的右半肝 S1 切除术。术后过程顺利,患者在 12 个月后无疾病。当肝再生通过 PVE 和干细胞给药增强时,极限肝切除术可以为那些原本无法切除的患者提供更安全的选择和治愈机会。