Liu Wei-Xing, Jiang Chuang, Li Jia-Xin
Department of Liver Surgery, West China Hospital, Chengdu 610041, Sichuan Province, China.
Division of Liver Surgery, Department of General Surgery and Laboratory of Liver Surgery, and State Key Laboratory of Biotherapy and Collaborative Innovation Center of Biotherapy, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China.
World J Clin Oncol. 2025 Jul 24;16(7):107438. doi: 10.5306/wjco.v16.i7.107438.
The incidence of colorectal cancer is gradually increasing, and a majority of patients are diagnosed with distant metastases at the time of initial diagnosis, with the liver being the most common site of metastasis. Unlike most malignant tumors, patients with distant metastases can still achieve favorable prognoses if both the primary tumor and liver metastases are surgically resected. With advances in systemic therapies, many patients with initially unresectable liver metastases from colorectal cancer can undergo systemic treatment to achieve conversion therapy, thereby gaining the opportunity for surgery. However, there is still no consensus on several issues, including the timing of systemic therapy before and after surgery, whether neoadjuvant therapy should be employed, and the choice between simultaneous or staged surgeries. This review aims to systematically describe the current treatment landscape for colorectal cancer with liver metastases and highlight several unresolved controversial issues, providing valuable insights for the diagnosis and treatment of colorectal liver metastases.
结直肠癌的发病率正在逐渐上升,大多数患者在初次诊断时就被诊断为远处转移,肝脏是最常见的转移部位。与大多数恶性肿瘤不同,如果原发肿瘤和肝转移灶都能通过手术切除,远处转移的患者仍可获得良好的预后。随着全身治疗的进展,许多最初无法切除的结直肠癌肝转移患者可以接受全身治疗以实现转化治疗,从而获得手术机会。然而,在几个问题上仍未达成共识,包括手术前后全身治疗的时机、是否应采用新辅助治疗以及同期手术还是分期手术的选择。本综述旨在系统地描述目前结直肠癌肝转移的治疗现状,并突出几个尚未解决的有争议问题,为结直肠癌肝转移的诊断和治疗提供有价值的见解。