Asbun H J, Tsao J I, Hughes K S
Lahey Clinic, Burlington, MA 01805.
Cancer Treat Res. 1994;69:33-41. doi: 10.1007/978-1-4615-2604-9_4.
When liver metastases from colorectal carcinoma are detected, the surgeon must decide whether or not the patient is a candidate for resection. Even though long-term survival after resection is far from optimal, the relegation of patients to nonresective treatment means denying them the only chance for cure currently available. Better understanding of liver anatomy and improvement in resection techniques have decreased the morbidity and mortality. The RHM and the GITSG reports have better defined the prognostic factors for resections of colorectal liver metastases and allowed for a better understanding of the indications for resection. During the last decades, liver resection has been extended to older patients, patients with multiple liver lesions, and patients with larger solitary metastases. At the same time, anatomic rather than wedge resections are more common, and it is preferable to perform the colon and liver resection at different stages. The end result has been a marked increase in the number of hepatic resections performed for colorectal liver metastases during the last two decades.
当检测到结直肠癌肝转移时，外科医生必须决定患者是否适合进行切除手术。尽管切除术后的长期生存率远非理想，但将患者归为非切除治疗意味着剥夺他们目前唯一的治愈机会。对肝脏解剖结构的更好理解以及切除技术的改进降低了发病率和死亡率。RHM和GITSG报告更好地界定了结直肠癌肝转移切除的预后因素，并有助于更好地理解切除指征。在过去几十年中，肝切除已扩展到老年患者、有多个肝病灶的患者以及有较大孤立转移灶的患者。同时，解剖性切除而非楔形切除更为常见，并且结肠和肝脏切除分阶段进行更为可取。最终结果是，在过去二十年中，因结直肠癌肝转移而进行的肝切除数量显著增加。
