Nakanishi Masayoshi, Kuriu Yoshiaki, Murayama Yasutoshi, Konishi Hirotaka, Komatsu Shuhei, Shiozaki Atsushi, Ikoma Hisashi, Kubota Takeshi, Ichikawa Daisuke, Fujiwara Hitoshi, Okamoto Kazuma, Sakakura Chohei, Otsuji Eigo
Hepatogastroenterology. 2014 Sep;61(134):1582-7.
BACKGROUND/AIMS: Although aggressive resection is recommended for the treatment of resectable liver metastasis of colorectal cancer, recurrences often develop in the remaining liver. In our department, perioperative chemotherapy was introduced for the treatment of colorectal cancer associated with resectable synchronous liver metastasis. The results of this treatment are reported herein. The study population was 20 patients (9 men, 11 women) with colorectal cancer associated with resectable synchronous liver metastasis whose data were collected between April 2009 and September 2012.
The patients received chemotherapy (mFOLFOX6 or XELOX + bevacizumab) for 3 months each before and after hepatectomy following resection of the primary lesion.
Preoperative chemotherapy yielded a response rate of 66.7%, and no serious postoperative complications were noted. Although recurrence was found in 9 patients after treatment, 4 have so far remained cancer-free after re-resection. Thus, re-resection of the recurrent lesion resulted in patients maintaining cancer-free status for a prolonged period.
The use of perioperative chemotherapy in patients with colorectal cancer associated with resectable synchronous liver metastasis may improve outcomes after hepatectomy.
背景/目的：尽管对于可切除的结直肠癌肝转移推荐进行积极切除，但复发常出现在剩余肝脏。在我们科室，引入了围手术期化疗来治疗伴有可切除的同时性肝转移的结直肠癌。本文报告了该治疗的结果。研究对象为20例（9例男性，11例女性）伴有可切除的同时性肝转移的结直肠癌患者，其数据于2009年4月至2012年9月期间收集。
患者在切除原发灶后，肝切除术前和术后均接受3个月的化疗（mFOLFOX6或XELOX + 贝伐单抗）。
术前化疗的缓解率为66.7%，未观察到严重的术后并发症。尽管治疗后9例患者出现复发，但目前4例在再次切除后仍无癌生存。因此，对复发病灶进行再次切除可使患者长期维持无癌状态。
对于伴有可切除的同时性肝转移的结直肠癌患者，使用围手术期化疗可能改善肝切除术后的结局。
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