Takemura Nobuyuki, Saiura Akio
Nobuyuki Takemura, Department of Gastroenterological Surgery, JR Tokyo General Hospital, Tokyo 151-8528, Japan.
World J Hepatol. 2017 Feb 18;9(5):242-251. doi: 10.4254/wjh.v9.i5.242.
It is widely accepted that the indications for hepatectomy in colorectal cancer liver metastases and liver metastases of neuro-endocrine tumors result in relatively better prognoses, whereas, the indications and prognoses of hepatectomy for non-colorectal non-neuroendocrine liver metastases (NCNNLM) remain controversial owing to the limited number of cases and the heterogeneity of the primary diseases. There have been many publications on NCNNLM; however, its background heterogeneity makes it difficult to reach a specific conclusion. This heterogeneous disease group should be discussed in the order from its general to specific aspect. The present review paper describes the general prognosis and risk factors associated with NCNNLM while specifically focusing on the liver metastases of each primary disease. A multidisciplinary approach that takes into consideration appropriate timing for hepatectomy combined with chemotherapy may prolong survival and/or contribute to the improvement of the quality of life while giving respite from systemic chemotherapy.
人们普遍认为,结直肠癌肝转移和神经内分泌肿瘤肝转移行肝切除术的指征可带来相对较好的预后,然而,由于病例数量有限以及原发疾病的异质性,非结直肠癌非神经内分泌肝转移(NCNNLM)行肝切除术的指征和预后仍存在争议。关于NCNNLM已有许多文献发表;然而,其背景异质性使得难以得出具体结论。应从一般到具体的顺序讨论这个异质性疾病组。本综述文章描述了与NCNNLM相关的一般预后和危险因素,同时特别关注每种原发疾病的肝转移。一种多学科方法,即考虑肝切除术的合适时机并结合化疗,可能会延长生存期和/或有助于改善生活质量,同时让患者从全身化疗中得到缓解。