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难点:转移性结肠癌的手术选择

The Ugly: Metastatic Colon Cancer-Surgical Options.

作者信息

Dossa Fahima, Weiser Martin R

机构信息

Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York.

出版信息

Clin Colon Rectal Surg. 2024 Jun 18;38(3):219-228. doi: 10.1055/s-0044-1787825. eCollection 2025 May.


DOI:10.1055/s-0044-1787825
PMID:40291995
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12020648/
Abstract

Over 50% of patients with colorectal cancer develop metastatic disease. Although systemic therapy remains the backbone of palliative treatment, select patients may be candidates for surgical resection with curative intent. Given increasing evidence of the association between metastasectomy and prolonged survival, surgery has acquired an increasingly central role in the management of liver, lung, and peritoneal metastases. This is compounded by accumulating advances in local and systemic treatments that have allowed for expansion of the resectability pool, bringing the potential for curative surgical treatment to increasing numbers of patients with stage IV disease. However, as the boundaries of resectability are pushed, patient selection and consideration of tumor-related and technical factors are imperative to the identification of patients for whom surgery would be of the greatest benefit.

摘要

超过50%的结直肠癌患者会发生转移性疾病。尽管全身治疗仍然是姑息治疗的主要手段,但部分患者可能适合进行旨在治愈的手术切除。鉴于越来越多的证据表明转移灶切除术与延长生存期相关,手术在肝、肺和腹膜转移瘤的治疗中发挥着越来越核心的作用。局部和全身治疗的不断进步使得可切除范围得以扩大,这使得越来越多的IV期疾病患者有机会接受根治性手术治疗,这种情况进一步凸显了手术的重要性。然而,随着可切除范围的扩大,为了确定能从手术中获益最大的患者,必须对患者进行筛选,并考虑肿瘤相关因素和技术因素。

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The Ugly: Metastatic Colon Cancer-Surgical Options.

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本文引用的文献

[1]
Treatment of Metastatic Colorectal Cancer: ASCO Guideline.

J Clin Oncol. 2023-1-20

[2]
The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for the Management of Colon Cancer.

Dis Colon Rectum. 2022-2-1

[3]
Sixty-Day Mortality of Patients With Metastatic Colorectal Cancer Randomized to Systemic Treatment vs Primary Tumor Resection Followed by Systemic Treatment: The CAIRO4 Phase 3 Randomized Clinical Trial.

JAMA Surg. 2021-12-1

[4]
Results of redo pulmonary metastasectomy.

J Thorac Dis. 2021-4

[5]
Surgery for Pulmonary Metastases: Long-Term Survival in 281 Patients.

Thorac Cardiovasc Surg. 2021-10

[6]
The Pulmonary Metastasectomy in Colorectal Cancer cohort study: Analysis of case selection, risk factors and survival in a prospective observational study of 512 patients.

Colorectal Dis. 2021-7

[7]
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J Natl Compr Canc Netw. 2021-3-2

[8]
Primary Tumor Resection Plus Chemotherapy Versus Chemotherapy Alone for Colorectal Cancer Patients With Asymptomatic, Synchronous Unresectable Metastases (JCOG1007; iPACS): A Randomized Clinical Trial.

J Clin Oncol. 2021-4-1

[9]
Cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy versus cytoreductive surgery alone for colorectal peritoneal metastases (PRODIGE 7): a multicentre, randomised, open-label, phase 3 trial.

Lancet Oncol. 2021-2

[10]
Does the presence of an intact primary increase the risk of nonelective colorectal surgery in patients treated with bevacizumab?

Colorectal Dis. 2020-12

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