Division of Surgical Oncology, Vanderbilt University School of Medicine, Nashville, TN 37232, USA.
Hepatobiliary Surg Nutr. 2015 Feb;4(1):80-3. doi: 10.3978/j.issn.2304-3881.2014.08.05.
The liver is the most common site of colorectal cancer metastasis. Although successful resection leads to durable overall survival (OS), local and distant recurrence is common. As a result, multidisciplinary strategies have been developed to decrease recurrence rates as well as increase the number of candidates for resection. A recent update to the European Organisation for Research and Treatment of Cancer (EORTC) Intergroup trial 40983 has been published comparing perioperative chemotherapy to surgery alone. This randomized trial initially demonstrated a benefit in progression free survival (PFS) with the administration of perioperative FOLFOX chemotherapy, albeit with an increased rate of complications. Although this led many investigators and clinicians to adopt the perioperative approach, the recent update failed to report any advantage in OS and therefore results in further controversy as to the role of perioperative systemic chemotherapy in the treatment of resectable colorectal hepatic metastases.
肝脏是结直肠癌转移的最常见部位。尽管成功的切除导致持久的总生存（OS），但局部和远处复发很常见。因此，已经制定了多学科策略来降低复发率并增加可切除的候选者数量。最近发表了欧洲癌症研究与治疗组织（EORTC）第 40983 组试验的更新，比较了围手术期化疗与单纯手术。这项随机试验最初显示，围手术期 FOLFOX 化疗的应用在无进展生存期（PFS）方面有获益，尽管并发症发生率增加。尽管这导致许多研究人员和临床医生采用围手术期方法，但最近的更新未能报告 OS 方面的任何优势，因此对于围手术期全身化疗在可切除结直肠肝转移中的治疗作用存在进一步的争议。
