Oliveira Cássio Virgílio Cavalcante de, Santana Rodolfo Carvalho, Coimbra Felipe José Fernandez, Kow Alfred, Pawlik Timothy M, Adam Rene, Soubrane Olivier, Herman Paulo, Cotta-Pereira Ricardo Lemos
Universidade Federal da Paraíba, Surgery Department of Surgery - João Pessoa (PB), Brazil.
São Rafael Hospital/Rede D'Or Hospital Group, Department of Surgery of the Upper Digestive System - Salvador (BA), Brazil.
Arq Bras Cir Dig. 2025 Apr 7;38:e1874. doi: 10.1590/0102-6720202500005e1874. eCollection 2025.
Deaths related to colorectal cancer are generally associated with its metastases that affect the liver (50%) through the hematogenous route. Approximately 20-25% of these patients already have synchronous metastases in the liver at the time of primary tumor diagnosis. In others, liver metastases will occur during the course of the disease and are called metachronous. Metachronous metastases are believed to have a better prognosis; however, 20-25% of metastatic cases can be resected during the course of the disease. There is a lack of consensus on the diagnostic time interval for metastases to be considered metachronous in the consulted literature. Surgical treatment of metastases and lymph nodes is indicated, and extrahepatic neoplastic disease must be carefully evaluated. Liver transplantation can benefit the patient, should be evaluated, and is indicated in some special situations.
与结直肠癌相关的死亡通常与其通过血行途径转移至肝脏（50%）有关。这些患者中约20 - 25%在原发性肿瘤诊断时肝脏已出现同步转移。在其他患者中，肝转移将在疾病过程中发生，称为异时性转移。异时性转移被认为预后较好；然而，20 - 25%的转移病例在疾病过程中可进行切除。在所查阅的文献中，对于转移灶被视为异时性转移的诊断时间间隔缺乏共识。转移灶和淋巴结的手术治疗是必要的，并且必须仔细评估肝外肿瘤性疾病。肝移植可能使患者受益，应进行评估，且在某些特殊情况下适用。
