结直肠癌寡转移疾病——如何应对？
Oligometastatic Disease in Colorectal Cancer - How to Proceed?
作者信息
Aigner Felix, Pratschke Johann, Schmelzle Moritz
机构信息
Department of Surgery, Charité - Universitätsmedizin Berlin, Campus Charité Mitte, Campus Virchow-Klinikum, Berlin, Germany.
出版信息
Visc Med. 2017 Mar;33(1):23-28. doi: 10.1159/000454688. Epub 2017 Feb 3.
Abstract
BACKGROUND
Oligometastatic disease in colorectal cancer may affect the liver, lung, and peritoneum. This review mainly focuses on colorectal liver metastases (CRLM) and highlights recommendations and therapeutic strategies drawn from the current literature and consensus conferences. The following data address a paradigm shift in surgical approaches to CRLM, pushing the limits of multimodal treatment concepts.
METHODS
A systematic review of the relevant literature on multimodal treatment strategies for synchronous and metachronous CRLM is presented.
RESULTS
The choice of treatment strategy depends on the clinical scenario; however, perioperative chemotherapy and the liver-first concept in synchronous CRLM are favored with subsequent partial extended liver resection with or without various augmentation techniques for liver surgery.
CONCLUSION
Surgical strategies should be strongly defined with regard to an adequate liver remnant. All patients with synchronous CRLM should be evaluated by a multidisciplinary team.
摘要
背景
结直肠癌寡转移可能累及肝脏、肺和腹膜。本综述主要聚焦于结直肠癌肝转移（CRLM），并着重介绍从当前文献和共识会议中得出的建议及治疗策略。以下数据阐述了CRLM手术方法的范式转变，拓展了多模式治疗理念的边界。
方法
对同步性和异时性CRLM多模式治疗策略的相关文献进行系统综述。
结果
治疗策略的选择取决于临床情况；然而，同步性CRLM倾向于围手术期化疗及肝优先理念，随后进行部分扩大肝切除术，可采用或不采用各种肝脏手术增强技术。
结论
应根据足够的肝剩余体积严格确定手术策略。所有同步性CRLM患者均应由多学科团队进行评估。
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