结直肠肝转移：肝移植在移植肿瘤学和精准医学时代的作用
Colon Rectal Liver Metastases: The Role of the Liver Transplantation in the Era of the Transplant Oncology and Precision Medicine.
作者信息
Finotti Michele, Vitale Alessandro, Gringeri Enrico, D'Amico Francesco Enrico, Boetto Riccardo, Bertacco Alessandra, Lonardi Sara, Bergamo Francesca, Feltracco Paolo, Cillo Umberto
机构信息
University of Padova, Transplantation and Hepatobiliary Surgery, Padua, Italy.
Unit of Oncology 1, Department of Oncology, Veneto Institute of Oncology IOV - Istituto di Ricovero e Cura a Carattere Scientifico, Padua, Italy.
出版信息
Front Surg. 2021 Jul 20;8:693387. doi: 10.3389/fsurg.2021.693387. eCollection 2021.
Abstract
The development of liver metastases in colon rectal cancer has a strong impact on the overall survival (OS) of the patient, with a 5-year survival rate of 5% with palliative treatment. Surgical resection combined with pharmacological treatment can achieve a 5-year OS rate of 31-58%. However, in only 20% of patients with colon rectal liver metastases (CRLMs), liver resection is feasible. In highly selected patients, recent trials and studies proved that liver transplantation (LT) for non-resectable CRLM is a surgical option with an excellent long-term OS. The paper aims to review the indications and outcome of LT for CRLMs, with a special focus on immunosuppressive therapy and the management of local and extrahepatic recurrence after LT.
摘要
结直肠癌肝转移的发生对患者的总生存期（OS）有重大影响，姑息治疗的5年生存率为5%。手术切除联合药物治疗可使5年OS率达到31% - 58%。然而，在仅20%的结直肠癌肝转移（CRLM）患者中，肝切除是可行的。在经过严格筛选的患者中，近期的试验和研究证明，对于不可切除的CRLM进行肝移植（LT）是一种具有出色长期OS的手术选择。本文旨在综述CRLM患者LT的适应证和结局，特别关注免疫抑制治疗以及LT后局部和肝外复发的管理。
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