Valderrama-Treviño Alan I, Barrera-Mera Baltazar, Ceballos-Villalva Jesús C, Montalvo-Javé Eduardo E
Department of Surgery, Universidad Nacional Autonoma de México, Ciudad de México, México.
Department of Physiology, Universidad Nacional Autonoma de México, Ciudad de México, México.
Euroasian J Hepatogastroenterol. 2017 Jul-Dec;7(2):166-175. doi: 10.5005/jp-journals-10018-1241. Epub 2017 Sep 29.
The liver is the most common site of metastasis in patients with colorectal cancer due to its anatomical situation regarding its portal circulation. About 14 to 18% of patients with colorectal cancer present metastasis at the first medical consultation, and 10 to 25% at the time of the resection of the primary colorectal cancer. The incidence is higher (35%) when a computed tomography (CT) scan is used. In the last decades, a significant increase in the life expectancy of patients with colorectal cancer has been achieved with different diagnostic and treatment programs. Despite these improvements, the presence of metastasis, disease recurrence, and advanced local tumors continue to remain poor prognostic factors. Median survival without treatment is <8 months from the moment of its presentation, and a survival rate at 5 years of 11% is the best prognosis for those who present with local metastasis. Even in patients with limited metastatic disease, 5-year survival is exceptional. Patients with hepatic metastasis of colorectal cancer have a median survival of 5 to 20 months with no treatment. Approximately 20 to 30% of patients with colorectal metastasis have disease confined to the liver, and this can be managed with surgery. Modern surgical strategies at the main hepatobiliary centers have proved that hepatectomy of 70% of the liver can be performed, with a mortality rate of <5%. It is very important to have knowledge of predisposing factors, diagnostic methods, and treatment of hepatic metastasis. However, the establishment of newer, efficient, preventive screening programs for early diagnosis and adequate treatment is vital. Valderrama-Treviño AI, Barrera-Mera B, Ceballos-Villalva JC, Montalvo-Javé EE. Hepatic Metastasis from Colorectal Cancer. Euroasian J Hepato-Gastroenterol 2017;7(2):166-175.
由于肝脏在门静脉循环方面的解剖位置,它是结直肠癌患者最常见的转移部位。约14%至18%的结直肠癌患者在首次就诊时出现转移,在原发性结直肠癌切除时这一比例为10%至25%。使用计算机断层扫描(CT)时发病率更高(35%)。在过去几十年中,通过不同的诊断和治疗方案,结直肠癌患者的预期寿命有了显著提高。尽管有这些改善,但转移的存在、疾病复发和局部晚期肿瘤仍然是不良预后因素。未经治疗的中位生存期自出现转移起不到8个月,出现局部转移患者的5年生存率为11%是最佳预后。即使是转移性疾病有限的患者,5年生存率也很低。结直肠癌肝转移患者未经治疗的中位生存期为5至20个月。约20%至30%的结直肠癌转移患者疾病局限于肝脏,这可以通过手术治疗。主要肝胆中心的现代手术策略已证明,可进行70%肝脏的肝切除术,死亡率<5%。了解肝转移的易感因素、诊断方法和治疗非常重要。然而,建立更新、有效的早期诊断和适当治疗的预防性筛查方案至关重要。瓦尔迪拉马 - 特雷维尼奥AI,巴雷拉 - 梅拉B,塞瓦洛斯 - 比利亚尔瓦JC,蒙塔尔沃 - 哈韦EE。结直肠癌肝转移。《欧亚肝脏胃肠病学杂志》2017年;7(2):166 - 17