Smith J Joshua, D'Angelica Michael I
Department of Surgery, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA.
Department of Surgery, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA.
Hematol Oncol Clin North Am. 2015 Feb;29(1):61-84. doi: 10.1016/j.hoc.2014.09.003.
For the 20% of patients with resectable colorectal liver metastases (CRLM), hepatic resection is safe, effective and potentially curative. Factors related to the primary and metastatic tumors individually and in clinical risk-scoring schemes are the best prognostic factors, although it is difficult to define patient groups with resectable, liver-limited CRLM that should be excluded from surgery. Systemic chemotherapy for metastatic colorectal cancer has improved but does not improve overall survival as adjuvant therapy after resection. Conversion to complete resection with systemic and/or hepatic arterial infusion chemotherapy is an appropriate goal for patients with unresectable CRLM.
对于20%可切除的结直肠癌肝转移（CRLM）患者，肝切除是安全、有效的，且有可能治愈。尽管难以界定哪些可切除、仅局限于肝脏的CRLM患者应被排除在手术之外，但原发肿瘤和转移瘤各自以及临床风险评分方案中的相关因素是最佳预后因素。转移性结直肠癌的全身化疗已有改善，但作为切除术后的辅助治疗并不能提高总生存率。对于不可切除的CRLM患者，通过全身和/或肝动脉灌注化疗转化为完全切除是一个合适的目标。
