Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard Unit 1484, Houston, TX, 77030, USA.
Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Ann Surg Oncol. 2020 Oct;27(11):4263-4270. doi: 10.1245/s10434-020-08777-z. Epub 2020 Aug 14.
Surgical resection remains the only curative treatment option for patients with colorectal liver metastases (CLM). However, the high recurrence rate after resection has led physicians to investigate multidisciplinary treatments combining surgery and medical therapy. Currently, the evidence to support medical therapy in patients with resectable CLM is limited. For patients with resectable CLM, the National Comprehensive Cancer Network Guidelines (version 2.2020) for colon and rectal cancer recommends either upfront surgery and postoperative adjuvant chemotherapy or preoperative chemotherapy followed by surgery and postoperative adjuvant chemotherapy. This article reviews randomized control trials regarding medical therapy before and after curative resection of CLM, and summarizes the updated long-term report of the New EPOC trial which investigated the addition of cetuximab to perioperative chemotherapy for patients with resectable CLM.
手术切除仍然是结直肠癌肝转移（CLM）患者唯一的治愈性治疗选择。然而，切除后的高复发率促使医生探索将手术与医学治疗相结合的多学科治疗方法。目前，支持可切除 CLM 患者使用医学治疗的证据有限。对于可切除 CLM 的患者，国家综合癌症网络指南（2020 年第 2 版）推荐在根治性切除 CLM 之前或之后进行手术和术后辅助化疗，或进行术前化疗，然后进行手术和术后辅助化疗。本文回顾了关于 CLM 根治性切除前后的医学治疗的随机对照试验，并总结了新的 EPOC 试验的最新长期报告，该试验研究了在可切除 CLM 患者的围手术期化疗中添加西妥昔单抗的效果。
