Calderon Novoa Francisco, Ardiles Victoria, de Santibañes Eduardo, Pekolj Juan, Goransky Jeremias, Mazza Oscar, Sánchez Claria Rodrigo, de Santibañes Martín
Department of Surgery, Division of HPB Surgery, Hospital Italiano de Buenos Aires, Buenos Aires C1199, Argentina.
Cancers (Basel). 2023 Apr 1;15(7):2113. doi: 10.3390/cancers15072113.
Colorectal cancer is the third most common cancer worldwide, and up to 50% of all patients diagnosed will develop metastatic disease. Management of colorectal liver metastases (CRLM) has been constantly improving, aided by newer and more effective chemotherapy agents and the use of multidisciplinary teams. However, the only curative treatment remains surgical resection of the CRLM. Although survival for surgically resected patients has shown modest improvement, this is mostly because of the fact that what is constantly evolving is the indication for resection. Surgeons are constantly pushing the limits of what is considered resectable or not, thus enhancing and enlarging the pool of patients who can be potentially benefited and even cured with aggressive surgical procedures. There are a variety of procedures that have been developed, which range from procedures to stimulate hepatic growth, such as portal vein embolization, two-staged hepatectomy, or the association of both, to technically challenging procedures such as simultaneous approaches for synchronous metastasis, ex-vivo or in-situ perfusion with total vascular exclusion, or even liver transplant. This article reviewed the major breakthroughs in liver surgery for CRLM, showing how much has changed and what has been achieved in the field of CRLM.
结直肠癌是全球第三大常见癌症，所有确诊患者中高达50%会发展为转移性疾病。在更新、更有效的化疗药物以及多学科团队的帮助下，结直肠癌肝转移（CRLM）的治疗一直在不断改进。然而，唯一的根治性治疗仍然是CRLM的手术切除。尽管接受手术切除患者的生存率有了一定提高，但这主要是因为不断变化的是切除指征。外科医生不断突破可切除与不可切除的界限，从而增加并扩大了能够通过积极手术程序潜在获益甚至治愈的患者群体。已经开发出了多种手术方法，从刺激肝脏生长的手术，如门静脉栓塞、分期肝切除术或两者联合，到技术上具有挑战性的手术，如同步转移的同期手术、完全血管阻断下的体外或原位灌注，甚至肝移植。本文回顾了CRLM肝脏手术的主要突破，展示了CRLM领域发生了多大的变化以及取得了哪些成就。
