Xu D, Xing B C
the First Department of Hepatopancreatobiliary Surgery, Key Laboratory of Carcinogenesis and Translational Research, Ministry of Education, Peking University School of Oncology, Beijing Cancer Hospital and Institute, Beijing 100142, China.
Zhonghua Zhong Liu Za Zhi. 2019 Feb 23;41(2):81-85. doi: 10.3760/cma.j.issn.0253-3766.2019.02.001.
The incidence of colorectal cancer liver metastasis (CRLM) has gradually increased in recent years. Surgical resection is the main method to achieve long-term survival for patients with CRLM. However, only 20% of these patients have the chance to undergo surgical resection. If the unresectable metastases can be converted to resectable ones by effective conversion therapy, the 5-year survival rate of patients received liver resection can exceed to 30%, which is significantly better than palliative treatment. Therefore, for patients who are initially unresectable, rationally developing a conversion therapy strategy to convert the initial unresectable CRLM into resectable ones is the key to improve the long-term survival of CRLM patients. However, there are still many controversies in clinical practice. In this article, we discuss three critical issues related to the conversion therapy for CRLM based on previous related researches and our experience, including the applicable population of conversion therapy, how to choose a conversion regime and the recognition and treatment of disappeared lesions after chemotherapy.
近年来，结直肠癌肝转移（CRLM）的发病率逐渐上升。手术切除是实现CRLM患者长期生存的主要方法。然而，这些患者中只有20%有机会接受手术切除。如果不可切除的转移灶能够通过有效的转化治疗转化为可切除的转移灶，接受肝切除的患者5年生存率可超过30%，这明显优于姑息治疗。因此，对于初始不可切除的患者，合理制定转化治疗策略，将初始不可切除的CRLM转化为可切除的转移灶，是提高CRLM患者长期生存的关键。然而，临床实践中仍存在许多争议。在本文中，我们基于以往相关研究和我们的经验，讨论与CRLM转化治疗相关的三个关键问题，包括转化治疗的适用人群、如何选择转化方案以及化疗后消失病灶的识别与处理。
