The Center for Cancer Prevention and Treatment, St Joseph Hospital, Orange, CA.
Clin Colorectal Cancer. 2013 Dec;12(4):223-32. doi: 10.1016/j.clcc.2013.06.006. Epub 2013 Sep 29.
This review article provides an overview of treatment options for patients with liver metastases, with a focus on the importance of response rates on resectability. The inclusion of surgery provides the only potential for cure in this setting. There are several important surgical considerations for performing resections, and close communication between oncologists and surgeons is important for achieving the intended outcome. In patients with initially unresectable colorectal liver metastases, an association between tumor response rate and resection rates has been demonstrated, implying that greater response rates could increase resection rates. Neoadjuvant chemotherapy establishes expected response rates with the use of biologic agents, such as cetuximab or bevacizumab, further improving the response rate and potentially increasing the rate of resection and potential to cure the disease.
这篇综述文章概述了肝转移患者的治疗选择,重点介绍了缓解率对可切除性的重要性。手术的加入为这种情况下的根治提供了唯一的可能。进行切除有几个重要的手术考虑因素,肿瘤学家和外科医生之间的密切沟通对于实现预期结果很重要。在最初不可切除的结直肠癌肝转移患者中,肿瘤缓解率与切除率之间存在关联,这意味着更高的缓解率可能会增加切除率。新辅助化疗通过使用生物制剂(如西妥昔单抗或贝伐珠单抗)确定预期的缓解率,进一步提高缓解率,并有可能增加切除率和治愈疾病的可能性。