Vahrmeijer A L, van Dierendonck J H, van de Velde C J
Department of Surgery, University Hospital, Leiden, The Netherlands.
Eur J Cancer. 1995 Jul-Aug;31A(7-8):1238-42. doi: 10.1016/0959-8049(95)00214-4.
Hepatic metastases are a major cause of death in patients with disseminated colorectal cancer. The prognosis of patients with hepatic metastases is very poor and mainly determined by the extent of hepatic disease at presentation. In these patients, the goal of any treatment is to obtain a complete tumour remission in the liver; this is the only way to obtain a significant survival benefit. In this overview, we summarise data from (i) studies comparing survival of patients after primary resection of liver metastases with survival after repeat liver resections, (ii) studies comparing hepatic arterial infusion of fluoropyrimidines with systemic delivery of these anticancer drugs, and (iii) phase I/II studies on isolated liver perfusion (ILP) with alkylating compounds. Furthermore, we discuss alternative strategies to combat liver metastases, including those taking advantage of an ILP setting.
肝转移是转移性结直肠癌患者死亡的主要原因。肝转移患者的预后很差，主要取决于初诊时肝脏疾病的范围。对于这些患者，任何治疗的目标都是使肝脏肿瘤完全缓解；这是获得显著生存获益的唯一途径。在本综述中，我们总结了以下几方面的数据：（i）比较肝转移瘤初次切除术后患者与再次肝切除术后患者生存率的研究；（ii）比较氟嘧啶肝动脉灌注与这些抗癌药物全身给药的研究；（iii）关于使用烷基化化合物进行离体肝脏灌注（ILP）的I/II期研究。此外，我们还讨论了对抗肝转移的替代策略，包括那些利用ILP环境的策略。
