Department of Surgery, University of Toronto, Toronto, ON M5G 2C4, Canada.
Department of Surgery, University Health Network, Toronto, ON M5G 1L7, Canada.
Curr Oncol. 2022 Jan 28;29(2):602-612. doi: 10.3390/curroncol29020054.
Up to 50% of colorectal cancer (CRC) patients develop colorectal liver metastases (CRLM). The aim of this study was to gauge the awareness and perception of liver transplantation (LT) for non-resectable CRLM, and to describe the current referral patterns and management strategies for CRLM in Canada. Surgeons who provide care for patients with CRC were invited to an online survey through the Canadian Association of General Surgeons, the Canadian Society of Colon and Rectal Surgeons, and the Canadian Society of Surgical Oncology. Thirty-seven surveys were included. The most utilized management strategy for CRLM was to refer to a hepatobiliary surgeon for assessment of metastectomy (78%), and/or refer to medical oncologists for consideration of chemotherapy (73%). Among the respondents, 84% reported that their level of knowledge about LT for CRLM was low, yet the perception of exploring the option of LT for non-resectable CRLM seemed generally favorable (81%). The decision to refer for consideration of LT for CRLM treatment seemed to depend on patient-specific factors and the local hepatobiliary surgeon's recommendation. Providing CRC care providers with educational materials on up-to-date CRLM management may help raise the awareness of the use of LT for non-resectable CRLM.
高达 50%的结直肠癌（CRC）患者会发展为结直肠肝转移（CRLM）。本研究旨在评估对不可切除的 CRLM 行肝移植（LT）的认知和看法，并描述加拿大目前针对 CRLM 的转诊模式和管理策略。通过加拿大普通外科医师协会、加拿大结直肠外科医师协会和加拿大外科肿瘤学会向为 CRC 患者提供治疗的外科医生发出了在线调查邀请。共纳入 37 份调查。针对 CRLM 最常用的管理策略是转至肝胆外科医生处评估切除术（78%）和/或转至肿瘤内科医生处考虑化疗（73%）。在受访者中，84%报告称他们对 CRLM 行 LT 的了解程度较低，但探索不可切除 CRLM 行 LT 这一选择的看法似乎普遍较为积极（81%）。决定是否转至考虑 LT 治疗 CRLM 似乎取决于患者的具体情况和当地肝胆外科医生的建议。为 CRC 治疗提供者提供关于最新 CRLM 管理的教育材料，可能有助于提高对不可切除 CRLM 行 LT 的认识。
