Yokoi Ryoma, Tajima Jesse Yu, Fukada Masahiro, Hayashi Hirokatsu, Kuno Masashi, Asai Ryuichi, Sato Yuta, Yasufuku Itaru, Kiyama Shigeru, Tanaka Yoshihiro, Murase Katsutoshi, Matsuhashi Nobuhisa
Department of Gastroenterological Surgery and Pediatric Surgery, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu City 501-1194, Gifu, Japan.
Cancers (Basel). 2023 Dec 27;16(1):142. doi: 10.3390/cancers16010142.
Colorectal cancer (CRC) is the third most common cancer, and nearly half of CRC patients experience metastases. Oligometastatic CRC represents a distinct clinical state characterized by limited metastatic involvement, demonstrating a less aggressive nature and potentially improved survival with multidisciplinary treatment. However, the varied clinical scenarios giving rise to oligometastases necessitate a precise definition, considering primary tumor status and oncological factors, to optimize treatment strategies. This review delineates the concepts of oligometastatic CRC, encompassing oligo-recurrence, where the primary tumor is under control, resulting in a more favorable prognosis. A comprehensive examination of multidisciplinary treatment with local treatments and systemic therapy is provided. The overarching objective in managing oligometastatic CRC is the complete eradication of metastases, offering prospects of a cure. Essential to this management approach are local treatments, with surgical resection serving as the standard of care. Percutaneous ablation and stereotactic body radiotherapy present less invasive alternatives for lesions unsuitable for surgery, demonstrating efficacy in select cases. Perioperative systemic therapy, aiming to control micrometastatic disease and enhance local treatment effectiveness, has shown improvements in progression-free survival through clinical trials. However, the extension of overall survival remains variable. The review emphasizes the need for further prospective trials to establish a cohesive definition and an optimized treatment strategy for oligometastatic CRC.
结直肠癌（CRC）是第三大常见癌症，近一半的CRC患者会发生转移。寡转移CRC代表一种独特的临床状态，其特征为转移累及有限，表现出侵袭性较低的特性，并且多学科治疗可能会改善生存。然而，由于引发寡转移的临床情况各异，因此需要综合考虑原发性肿瘤状态和肿瘤学因素给出精确的定义，以优化治疗策略。本综述阐述了寡转移CRC的概念，包括寡复发，即原发性肿瘤得到控制，从而有更良好的预后。文中还全面考察了局部治疗和全身治疗的多学科治疗方法。治疗寡转移CRC的首要目标是彻底根除转移灶，带来治愈的希望。这种治疗方法的关键在于局部治疗，手术切除是标准的治疗方式。对于不适合手术的病灶，经皮消融和立体定向体部放疗提供了侵入性较小的替代方案，在部分病例中显示出疗效。围手术期全身治疗旨在控制微转移疾病并提高局部治疗效果，通过临床试验已显示出无进展生存期有所改善。然而，总生存期的延长情况仍不尽相同。该综述强调需要进一步开展前瞻性试验，以确立针对寡转移CRC的连贯定义和优化治疗策略。
