The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX, 1484, USA.
Langenbecks Arch Surg. 2022 Aug;407(5):1765-1778. doi: 10.1007/s00423-022-02496-7. Epub 2022 Apr 9.
The liver is the most common site of metastasis for patients with colorectal cancer, and resection is associated with significantly improved survival for selected patients. Advancements in perioperative care, operative technique, and multidisciplinary management have led to improved outcomes for patients with colorectal liver metastases (CLM).
This review discusses recent advances in perioperative management, patient selection and prognostication, and surgical technique that make up the state-of-the-art management for patients with CLM.
Novel approaches to prognostication and measurement of treatment response, such as tumor somatic mutational profiling and circulating tumor DNA (ctDNA), are revolutionary instruments for patient selection and treatment sequence. Further, refinements to surgical approaches for patients with bilateral CLM, including two-stage hepatectomy (TSH), are available for these patients and may lead to improved surgical outcomes. The advances discussed in this review will result in more patients being considered for resection and refined selection for perioperative care strategies that will lead to improved survival for patients with CLM.
肝脏是结直肠癌患者最常见的转移部位，对某些患者进行切除术与显著改善生存率相关。围手术期护理、手术技术和多学科管理的进步使结直肠肝转移（CLM）患者的预后得到改善。
本综述讨论了围手术期管理、患者选择和预后预测以及外科技术方面的最新进展，这些进展构成了 CLM 患者的最新治疗管理方法。
肿瘤体细胞突变分析和循环肿瘤 DNA（ctDNA）等用于预后预测和治疗反应评估的新方法是患者选择和治疗顺序的革命性手段。此外，对于双侧 CLM 患者，包括两阶段肝切除术（TSH），也有更精细的手术方法，这些方法可能会改善手术结果。本综述中讨论的进展将使更多的患者被考虑进行切除术，并对围手术期护理策略进行精细化选择，从而提高 CLM 患者的生存率。
