Gong T Y, Yu M H, Zhong M
Department of Gastrointestinal Surgery, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200127, China.
Zhonghua Wei Chang Wai Ke Za Zhi. 2021 Mar 25;24(3):279-282. doi: 10.3760/cma.j.cn.441530-20200213-00053.
Surgery is recognized as the core treatment for colorectal liver metastasis (CRLM), while its recurrence rate remains relatively high, even for resectable CRLM. This hints that the efficacy of treatment involves not only technological factors of surgery, but also biological behavior of tumor. For resectable CRLM, neoadjuvant therapy is beneficial to eliminate the micro-metastasis, reduce postoperative recurrence rate, screen tumor biological behavior and improve prognosis. However, questions about which kind of CRLM patients fits for neoadjuvant therapy and what regimen should be used are still debatable. This paper reviews stratified management of resectable CRLM, choice of neoadjuvant regimen, especially the application value of targeted therapy, based on the latest guidelines and studies.
手术被认为是结直肠癌肝转移(CRLM)的核心治疗方法,但其复发率仍然相对较高,即使是可切除的CRLM也是如此。这表明治疗效果不仅涉及手术的技术因素,还涉及肿瘤的生物学行为。对于可切除的CRLM,新辅助治疗有利于消除微转移、降低术后复发率、筛查肿瘤生物学行为并改善预后。然而,关于哪种CRLM患者适合新辅助治疗以及应使用何种方案仍存在争议。本文基于最新指南和研究,综述了可切除CRLM的分层管理、新辅助方案的选择,尤其是靶向治疗的应用价值。