Mauri Giovanni, Monfardini Lorenzo, Garnero Andrea, Zampino Maria Giulia, Orsi Franco, Della Vigna Paolo, Bonomo Guido, Varano Gianluca Maria, Busso Marco, Gazzera Carlo, Fonio Paolo, Veltri Andrea, Calandri Marco
Divisione di Radiologia Interventistica, Istituto Europeo di Oncologia, IRCCS, 20141 Milan, Italy.
Dipartimento di Oncologia ed Emato-Oncologia, Università degli Studi di Milano, 20122 Milan, Italy.
Cancers (Basel). 2021 May 26;13(11):2617. doi: 10.3390/cancers13112617.
Colorectal cancer (CRC) is the third most common cancer worldwide and has a high rate of metastatic disease which is the main cause of CRC-related death. Oligometastatic disease is a clinical condition recently included in ESMO guidelines that can benefit from a more aggressive locoregional approach. This review focuses the attention on colorectal liver metastases (CRLM) and highlights recommendations and therapeutic locoregional strategies drawn from the current literature and consensus conferences. The different percutaneous therapies (radiofrequency ablation, microwave ablation, irreversible electroporation) as well as trans-arterial approaches (chemoembolization and radioembolization) are discussed. Ablation margins, the choice of the imaging guidance as well as characteristics of the different ablation techniques and other technical aspects are analyzed. A specific attention is then paid to the increasing role of biomarkers (in particular molecular profiling) and their role in the selection of the proper treatment for the right patient. In conclusion, in this review an up-to-date state of the art of the application of locoregional treatments on CRLM is provided, highlighting both technical aspects and the role of biomarkers, two sides of the same coin.
结直肠癌（CRC）是全球第三大常见癌症，其转移性疾病发生率很高，这是CRC相关死亡的主要原因。寡转移性疾病是一种最近被纳入欧洲肿瘤内科学会（ESMO）指南的临床情况，可从更积极的局部区域治疗方法中获益。本综述将重点关注结直肠癌肝转移（CRLM），并强调从当前文献和共识会议中得出的建议及局部区域治疗策略。文中讨论了不同的经皮治疗方法（射频消融、微波消融、不可逆电穿孔）以及经动脉治疗方法（化疗栓塞和放射性栓塞）。分析了消融边缘、成像引导的选择以及不同消融技术的特点和其他技术方面。随后特别关注生物标志物（尤其是分子谱分析）日益增加的作用及其在为合适的患者选择合适治疗方法中的作用。总之，本综述提供了CRLM局部区域治疗应用的最新技术水平，突出了技术方面和生物标志物的作用，这两者是同一事物的两个方面。
