Department of Surgery, Campus Charité Mitte | Campus Virchow-Klinikum, Charité - Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
Berlin Institute of Health at Charité - Universitätsmedizin Berlin, BIH Academy, Clinician Scientist Program, Berlin, Germany.
BMC Cancer. 2024 Oct 10;24(1):1260. doi: 10.1186/s12885-024-13008-9.
Multimodal two-stage hepatectomy (mTSH) is used in patients with bilobar colorectal liver metastases (CRLM) that cannot be treated with one surgical procedure due to insufficient future liver remnant. Interval chemotherapy has been proposed to improve disease control in CRLM patients undergoing mTSH. We here present a narrative review of clinical studies on mTSH including the use of interval chemotherapy in patients with CRLM.
A systematic literature search of the PubMed databases as well as the ClinicalTrials.gov registry was performed.
The use of interval chemotherapy during mTSH was reported in 23 studies and applied in 595 out of 1,461 patients with CRLM. Two studies report on the actual effects of this treatment, one study describes a trend towards improved disease progression rate. No serious adverse events caused by interval chemotherapy were observed. There is currently no randomized clinical trial investigating the efficacy and safety of interval chemotherapy during mTSH.
The currently available data indicate that interval chemotherapy does neither impair liver hypertrophy during mTSH nor cause procedure-associated complications in patients with CRLM. Results from randomized clinical trials on the potential positive effect on disease control are not yet available.
对于因未来剩余肝脏不足而无法通过单次手术治疗的双侧结直肠癌肝转移（CRLM）患者，可采用两阶段多模态肝切除术（mTSH）。有研究提出，在接受 mTSH 的 CRLM 患者中应用间隔化疗可以改善疾病控制。本文对 mTSH 相关的临床研究，包括 CRLM 患者中应用间隔化疗的研究进行了综述。
对 PubMed 数据库和 ClinicalTrials.gov 注册中心进行系统文献检索。
有 23 项研究报告了 mTSH 期间应用间隔化疗的情况，595 例 CRLM 患者接受了该治疗，占总数的 595/1461。有两项研究报告了该治疗的实际效果，其中一项研究表明疾病进展率有改善趋势。未观察到间隔化疗引起的严重不良事件。目前尚无随机临床试验研究 mTSH 期间间隔化疗的疗效和安全性。
目前的数据表明，间隔化疗既不会影响 mTSH 期间的肝再生，也不会导致 CRLM 患者出现与手术相关的并发症。关于其对疾病控制潜在积极影响的随机临床试验结果尚未得出。
