Blackham Aaron U, Swett Katrina, Levine Edward A, Shen Perry
Department of General Surgery, Wake Forest School of Medicine, Winston-Salem, NC, USA.
Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA.
Colorectal Cancer. 2013 Feb;2(1):73-88. doi: 10.2217/crc.12.80.
Over the past 30 years, the treatment of metastatic colorectal cancer to the liver has undergone major changes. Once considered terminal and incurable, the prognosis of patients with colorectal hepatic metastases has seen dramatic improvements using modern multimodality therapy and now long-term survival and even cure are possible in some patients. Despite the advances seen in systemic therapy, hepatic resection offers the longest survival potential and remains the only curative option. Based on long-term outcomes and the improved safety of hepatic resection using modern operative techniques and critical care support, an aggressive locoregional approach to colorectal hepatic metastasis has become the standard of care. This article focuses on the management of colorectal hepatic metastases and highlights the importance of multimodality therapy. We also report our 18-year experience treating patients with hepatic resection for colorectal metastases.
在过去30年中，转移性结直肠癌肝转移的治疗发生了重大变化。结直肠癌肝转移患者的预后曾经被认为是终末期且无法治愈的，但使用现代多模式疗法后有了显著改善，现在一些患者有可能实现长期生存甚至治愈。尽管全身治疗取得了进展，但肝切除术提供了最长的生存潜力，仍然是唯一的治愈选择。基于长期结果以及使用现代手术技术和重症监护支持提高了肝切除术的安全性，对结直肠癌肝转移采取积极的局部区域治疗方法已成为标准治疗方案。本文重点关注结直肠癌肝转移的管理，并强调多模式疗法的重要性。我们还报告了我们18年来治疗结直肠癌肝转移患者行肝切除术的经验。
