Schwartz S I
Department of Surgery, University of Rochester School of Medicine and Dentistry, New York 14642, USA.
World J Surg. 1995 Jan-Feb;19(1):72-5. doi: 10.1007/BF00316982.
The experience with hepatic resection for metastatic lesions, exclusive of colorectal and neuroendocrine tumors, is anecdotal. The reduction in operative mortality leads to a reconsideration of the subject. A review of the literature suggests a selective approach. There is little improvement to be anticipated for resection of metastases from tumors of the esophagus, stomach, small intestine, or pancreas. Resection of metastases from primary renal cell carcinoma, Wilms' tumor, and adrenocortical carcinoma is indicated. There is little to recommend resection of metastases from gynecologic or breast primary carcinomas. Resection as palliation is to be considered for all lesions, particularly bulky metastases from ocular melanomas.
对于转移性病变（不包括结直肠癌和神经内分泌肿瘤）进行肝切除术的经验只是个别案例。手术死亡率的降低促使人们重新审视这个问题。文献综述表明应采取选择性方法。对于食管、胃、小肠或胰腺肿瘤的转移灶切除，预期改善甚微。对于原发性肾细胞癌、肾母细胞瘤和肾上腺皮质癌的转移灶，建议进行切除。对于妇科或乳腺原发性癌的转移灶，几乎没有理由进行切除。对于所有病变，尤其是眼部黑色素瘤的巨大转移灶，应考虑将切除作为一种姑息治疗手段。
