Kimura T, Akazai Y, Iwagaki H, Nonaka Y, Ariki N, Fuchimoto S, Hizuta A, Tanaka N, Orita K
First Department of Surgery, Okayama University Medical School, Japan.
Anticancer Res. 1995 Jul-Aug;15(4):1585-8.
We estimated the time of occurrence of metachronous liver metastasis in colorectal cancer patients from tumor diameter and doubling time. Micro-metastasis was present prior to operation in most patients and a few metastatic cases could have been initiated by the surgical procedure. Portal chemotherapy is more effective against liver metastasis than intravenous infusion because a higher drug concentration in the liver can be obtained. This efficacy of portal chemotherapy on survival was also observed in a rat model. Thus perioperative adjuvant treatment should be undertaken for metastasis which already existed before the operation and adjuvant chemotherapy via portal vein is the treatment of choice. The no touch isolation technique is also needed to avoid spreading of tumor cells during surgery.
我们根据肿瘤直径和倍增时间估算了结直肠癌患者异时性肝转移的发生时间。大多数患者在手术前就已存在微转移，少数转移病例可能是由手术操作引发的。门静脉化疗比静脉输注对肝转移更有效，因为可以在肝脏中获得更高的药物浓度。在大鼠模型中也观察到了门静脉化疗对生存的这种疗效。因此，对于术前已存在的转移应进行围手术期辅助治疗，门静脉辅助化疗是首选治疗方法。还需要采用非接触隔离技术以避免手术过程中肿瘤细胞的扩散。
