Nordlinger B, Quilichini M A, Parc R, Hannoun L, Delva E, Huguet C
Int Surg. 1987 Apr-Jun;72(2):70-2.
Surgical resection is currently the only potentially curative treatment in some selected patients with colo-rectal liver metastases (LM). Unfortunately only a minority of patients are candidates for resection. Only solitary or unilobar LM that can be removed by partial liver resection, are considered to be resectable. The second condition for the resection of LM is that the primary cancer must be resected. The third condition for resection is that the patient must be able to undergo a major liver resection if it is necessary. Small metastases which do not exceed 5 cm, and appear on the surface of the liver can be removed by a simple wedge resection. If the tumor is larger than 5 cm, or if multiple unilobar nodules are discovered, a major liver resection becomes necessary. Hospital mortality does not exceed 5% in most published series. Five year survivals are very rare when histologically proven colo-rectal LM are left in place. After surgical resection of LM, five year survival rates are close to 25% and range from 18% to 52%. Surgical resection is of benefit to approximately one fourth of the patients, who survive five years or more, but three fourths of the patients have early recurrences. None of the studied criteria can predict which patients will benefit from surgical resection of LM. In order to try to reduce the rate of early recurrences adjuvant chemotherapy has been proposed. No positive data have yet been obtained.
手术切除目前是一些选定的结直肠癌肝转移（LM）患者唯一可能治愈的治疗方法。不幸的是，只有少数患者适合手术切除。只有通过部分肝切除能够切除的孤立性或单叶性肝转移灶才被认为是可切除的。肝转移灶切除的第二个条件是原发性癌症必须切除。切除的第三个条件是患者在必要时必须能够接受大的肝切除。不超过5厘米且位于肝脏表面的小转移灶可通过简单的楔形切除术切除。如果肿瘤大于5厘米，或者发现多个单叶结节，则需要进行大的肝切除。在大多数已发表的系列研究中，医院死亡率不超过5%。当组织学证实的结直肠癌肝转移灶未切除时，五年生存率非常罕见。肝转移灶手术切除后，五年生存率接近25%，范围在18%至52%之间。手术切除对大约四分之一能存活五年或更长时间的患者有益，但四分之三的患者会早期复发。所研究的标准中没有一个能够预测哪些患者将从肝转移灶的手术切除中获益。为了试图降低早期复发率，人们提出了辅助化疗。但尚未获得阳性数据。
