Binnebösel M, Lambertz A, Dejong K, Neumann U P
Klinik für Allgemein‑, Viszeral- und Transplantationschirurgie, Uniklinik der RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Deutschland.
Department of Surgery, University Medical Center Maastricht, Maastricht, Niederlande.
Chirurg. 2018 Jul;89(7):497-504. doi: 10.1007/s00104-018-0661-y.
The prognosis of colorectal cancer in UICC stage IV has been improved in the last decades by improvements in interdisciplinary treatment.
Treatment strategies for oligometastasized colorectal cancer are developing more and more into an individualized treatment. An overview of the current literature of modern treatment concepts in oligometastasized colorectal cancer UICC stage IV is given.
Surgery still has the supreme mandate in resectable colorectal liver metastases, as neoadjuvant and adjuvant treatment strategies to not provide any benefits for these patients. In marginal or non-resectable stages systemic treatment is superior in these patients depending on the prognostic parameters. Also in curative settings local treatment options should be considered as a reasonable additive tool. An interesting treatment approach for isolated liver metastases and non-resectable colorectal cancer is liver transplantation.
Irrespective of new developments in treatment strategies for metastasized colorectal cancer, resection of colorectal liver metastases remains the gold standard whenever possible.
在过去几十年中，通过多学科治疗的改进，国际抗癌联盟（UICC）IV期结直肠癌的预后得到了改善。
寡转移结直肠癌的治疗策略越来越趋向于个体化治疗。本文对UICC IV期寡转移结直肠癌现代治疗理念的当前文献进行了综述。
对于可切除的结直肠癌肝转移，手术仍然具有最高的优先级，因为新辅助和辅助治疗策略对这些患者没有任何益处。在边缘性或不可切除阶段，根据预后参数，全身治疗对这些患者更具优势。在根治性治疗中，局部治疗方案也应被视为一种合理的辅助手段。肝移植是孤立性肝转移和不可切除结直肠癌的一种有趣的治疗方法。
无论转移性结直肠癌治疗策略有何新进展，只要有可能，结直肠癌肝转移的切除仍然是金标准。
