Langer B
Can J Surg. 1985 Sep;28(5):419-21.
The best opportunity for cure in colorectal cancer is early diagnosis and complete excision of the primary disease. Currently, metastatic disease develops in about 50% of patients, most often in the liver. Resection of solitary liver metastases is warranted, and a 5-year survival of at least 25% can be expected. Patients with limited unilobar multiple metastases may also benefit from resection. Extensive metastatic disease to the liver may respond to single or combination chemotherapy. Response rates are highest with hepatic artery infusion chemotherapy, but improvement in survival has not clearly been shown. Solitary or limited lung metastases, when unassociated with other metastatic disease, should also be resected. Multiorgan involvement may respond to systemic chemotherapy but results are generally poor. Palliation is an important objective of therapy, involving not only anticancer treatment (surgery, chemotherapy, radiotherapy) but also general supportive care.
结直肠癌治愈的最佳时机是早期诊断并彻底切除原发性疾病。目前，约50%的患者会发生转移性疾病，最常见于肝脏。孤立性肝转移瘤切除术是必要的，预计5年生存率至少为25%。单叶多发转移受限的患者也可能从切除术中获益。广泛的肝转移瘤可能对单药或联合化疗有反应。肝动脉灌注化疗的缓解率最高，但尚未明确显示出生存率的改善。孤立性或局限性肺转移，若与其他转移性疾病无关，也应切除。多器官受累可能对全身化疗有反应，但总体结果通常较差。姑息治疗是治疗的一个重要目标，不仅涉及抗癌治疗（手术、化疗、放疗），还包括一般支持治疗。
