Anselmo Alessandro, Cascone Chiara, Siragusa Leandro, Sensi Bruno, Materazzo Marco, Riccetti Camilla, Bacchiocchi Giulia, Ielpo Benedetto, Rosso Edoardo, Tisone Giuseppe
Department of Surgical Science, University of Rome "Tor Vergata", 00133 Roma, Italy.
Department of Surgery, University Campus Bio-Medico di Roma, 00128 Roma, Italy.
Healthcare (Basel). 2022 Sep 28;10(10):1898. doi: 10.3390/healthcare10101898.
The development of new systemic treatment strategies has resulted in a significant increase in the response rates of colorectal liver metastases (CRLM) in the last few years. Although the radiological response is a favorable prognostic factor, complete shrinkage of CRLM, known as disappearing liver metastases (DLM), presents a therapeutic dilemma, and proper management is still debated in the literature. In fact, DLM is not necessarily equal to cure, and when resected, pathological examination reveals in more than 80% of patients a variable percentage of the tumor as residual disease or early recurrence in situ. Moreover, while a higher incidence of intrahepatic recurrence is documented in small series when surgery is avoided, its clinical significance for long-term OS is still under investigation. In light of this, a multidisciplinary approach and, in particular, radiologists' role is needed to assist the surgeon in the management of DLM, thanks to emerging technology and strategy. Therefore, the aim of this review is to provide an overview of the DLM phenomenon and current management.
在过去几年中，新的全身治疗策略的发展使结直肠癌肝转移（CRLM）的缓解率显著提高。尽管放射学缓解是一个有利的预后因素，但CRLM完全缩小，即所谓的肝转移消失（DLM），带来了治疗困境，文献中对于其恰当的处理仍存在争议。事实上，DLM不一定等同于治愈，切除后病理检查显示，超过80%的患者存在不同比例的肿瘤残留或原位早期复发。此外，虽然在少数未进行手术的病例中记录到肝内复发的发生率较高，但其对长期总生存期的临床意义仍在研究中。鉴于此，由于新兴技术和策略的出现，需要采用多学科方法，特别是放射科医生要在DLM的管理中协助外科医生。因此，本综述的目的是概述DLM现象及当前的处理方法。
