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结直肠癌是常见的肿瘤之一,近一半的患者最终会发生肝转移,肝转移灶切除是唯一的治愈方法。对于评估为可切除的肝转移灶,由于其术后复发率高,患者生存时间并未有显著延长,术前影像学难以发现的肝内微小转移灶成为局部复发的重要因素之一。术前化疗可以减少微小转移灶,增加R0切除(完整切除)率,减少术后复发风险。但是,是否所有术前评估为可切除肝转移灶的结直肠癌患者均可以从术前化疗中获益仍存在争议。 相似文献
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结直肠癌肝转移治疗进展 总被引:3,自引:0,他引:3
结直肠癌肝转移是影响结直肠癌患者生存率的主要原因,目前对其治疗尚无最佳方案。肝叶切除术是治疗肝转移癌的“金标准”,对于3个以下的肝脏转移灶,行肝叶切除术是最佳选择。而对于无手术指征的肝转移患者,使用去氧氟尿苷的肝动脉化疗可获得较高的缓解率。随着生理周期化疗、基因治疗、射频消融治疗、肝血流阻断灌注治疗等方法的发展,结直肠癌肝转移患者的治愈率有望获得提高。 相似文献
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目的 探讨腹腔镜下行结直肠癌切除术同时处理合并肝转移癌的疗效。方法 对32例结直肠癌合并肝转移患者行腹腔镜下结直肠癌切除手术,同时利用腹腔镜直视下切除或射频消融等方法治疗肝转移癌。结果 32例患者手术过程顺利,手术时间为220~384min,平均280min,出血量为240~1300ml,无严重并发症发生。随访6~32月,18例存活,7例死于肺、脑或腹腔转移,3例死于复发,2例死于脑出血,2例死于心肌梗塞。结论 利用腹腔镜直视下治疗结直肠癌并肝转移安全有效,可避免二期手术的创伤。 相似文献
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结直肠癌肝转移的治疗 总被引:1,自引:0,他引:1
结直肠癌是常见的恶性肿瘤之一 ,肝脏是结直肠癌常见的远处转移器官 ,结直肠癌患者最终约有 5 0 %发生肝转移[1] 。如何处理结直肠癌肝转移 ,是改善结直肠癌预后的 1个重要研究课题 ,我们对此作一综述。1 手术治疗结直肠癌肝转移患者行肝切除术是获得治愈的首选治疗手段 ,术后 5年生存率达 2 5 %~ 40 % [2~ 4 ] 。Nordlinger等[3] 报道80例 ,其中 44例为单发性 ,36例为多发性 ;局限于 1叶者 76例 ,2叶者 4例 ;43例为同时性肝转移癌 (synchronouslivermetastases) ,37例为异时性肝转移癌 (metac… 相似文献
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目前手术切除是结直肠癌肝转移(CRLM)唯一具有治愈可能的治疗方式。近年来随着全身化疗及靶向药物的发展、肝动脉灌注化疗的应用,对于CRLM 治疗的有效率明显升高,通过手术获益的患者逐渐增多;而如射频消融、二步切除等外科技术的进步,也为更多CRLM 患者提供了治愈的机会。多学科诊疗模式(MDT )也为更多CRLM 患者的个体化诊治创造了机会,使未来CRLM 的治疗向更加精准的方向发展。 相似文献
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结直肠癌是威胁人类健康的重要疾病之一,世界范围每年有超过1百万的新发病例,将近50万的患者死于该病。其发病率位于欧美发达国家恶性肿瘤第3位,死亡率位于第2位[1]。我国结直肠癌发病率呈上升趋势,发病率位于恶性肿瘤的第3位,而病死率位于第5位[2]。约有25%的患者在确诊结直肠癌时发现肝转移,另有25%在疾病进展过程中出现肝转移,最终约2/3的患者死于肝转移[3]。以往结直肠癌出现肝转移被认为是晚期的表现,无积极治疗的价 相似文献
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对于结直肠癌肝转移病人,肝切除术彻底清除转移病灶被认为是目前的首选疗法.随着技术的进步,手术的适应证得到了很大拓展,主要决定于手术切除的可行性.化疗、消融治疗作为传统的辅助疗法,近年亦得到不断完善.而新出现的许多分子生物学疗法正得到迅速发展,部分已进入临床研究阶段,显示出较好的耐受性,并在部分患者的治疗中取得了良好效果.联合应用这些疗法以获得更佳的疗效,有着远大的前景. 相似文献
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A patient is described in whom the first recurrence of a cloacogenic carcinoma of the rectum was an intrahepatic metastasis associated with an hepatic abscess caused by the anaerobic bacterium Peptococcus prevotii. Three previously reported cases of infection associated with hepatic tumor nodules have been found in which bacteriologic data were provided, and in all three cases anaerobic bacteria were the primary or only infection organisms. Experimental data exist which document the ability of certain anaerobic bacteria to grow selectively in tumor nodules, but not in the normal tissues of a tumor-bearing host. Since 23% of patients with liver metastases have fever and offer a clinical picture compatible with infection, occult anaerobic infection associated with liver metastases may be more common than previously recognized. 相似文献
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A neurogenic sarcoma without NF-1 was discovered in a 73-year-old woman in the anorectal region, an unusual site for these tumors. The tumor was of high-grade malignancy and deeply located with mesorectal infiltration; it did not originate from a major nerve. We presume an origin from less differentiated neural crest cells and present a review of the literature on the best treatment for these neoplasms. 相似文献
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We present a rare case of small cell carcinoma of the rectum presenting with rectal bleeding and discomfort in a fit 51-year-old gentleman. Our patient was treated with a combination of chemotherapy and radiotherapy and remains alive and free of disease 6 years after diagnosis. Our patient experience and review of the literature is presented highlighting the uncertainties regarding the biological behaviour and management. 相似文献
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Metastatic brain tumors from colorectal cancer are relatively rare. In previous reports the incidence ranged from 1.9 to 3.5 percent of all metastatic brain tumors. In another recent article the cumulative incidence of brain metastasis was estimated at 1.2%. The prognosis for patients with even a single resectable brain metastasis is poor. This paper presents the case report of a 72-year-old woman with a solitary brain metastasis 16 years after a diagnosis of colorectal cancer. She remained asymptomatic for 16 years. The first sign of a secondary tumor was diplopia. Brain scan demonstrated a space-occupying lesion in the occipital area. A solitary tumor was removed by craniotomy. Histological examination showed that it was a metastasis from the intestinal primary tumor. The patient subsequently underwent whole brain radiotherapy for a total dose of 30 Gy in 10 fractions. 相似文献
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Y Naomoto H Sadamori H Matsukawa Y Shirakawa T Yamatsuji S Saito N Hino H Isozaki N Takakura N Tanaka 《Japanese journal of clinical oncology》1999,29(8):390-394
The prognosis of patients with hepatic metastasis from breast cancer is usually extremely poor. We present the case of a 39-year-old Japanese woman diagnosed with multiple liver metastasis from breast cancer. A novel approach consisting of hormone-cytokine-chemotherapy with an arterial infusion therapy was carried out. Computed tomography and ultrasonography revealed that the multiple liver metastases were reduced with remaining calcification. Tumor markers decreased rapidly. Complete regression was achieved after these treatments. To date, there has been no relapse during the 8-year follow-up period. These results suggest that the hormone-cytokine-chemotherapy might be a rational modality of treatment against multiple metastatic breast cancer. 相似文献
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Introduction
Breast cancer is one of the most commonly seen malignant tumors in the female population, and it ranks the first in the incidence of malignancies among women. The skeleton is a common metastatic site for advanced breast cancer and is where spinal metastasis is most frequently seen. The incidence rate of spinal metastasis in descending order is as follows: thoracic vertebrae, lumbar vertebrae, sacrococcygeal vertebrae and cervical vertebrae. 相似文献
Breast cancer is one of the most commonly seen malignant tumors in the female population, and it ranks the first in the incidence of malignancies among women. The skeleton is a common metastatic site for advanced breast cancer and is where spinal metastasis is most frequently seen. The incidence rate of spinal metastasis in descending order is as follows: thoracic vertebrae, lumbar vertebrae, sacrococcygeal vertebrae and cervical vertebrae. 相似文献
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This is the first clinical case report of a thoracic invasive thymoma metastatic to the ovary with disease noted in the entire abdomen including the pelvis 5 1/2 years after initial diagnosis. The involved areas of metastases include the distal ileum, peritoneal and serosal surfaces (including the surface of the distal colon, bladder, and pelvis), and the surface of the right ovary. The patient survived 13 years after her initial diagnosis and 7 1/2 years after discovery of her metastases. Thymomas are rare tumors but comprise the most common primary tumor of the anterior mediastinum. Extrathoracic metastases of malignant thymomas are also rare, and the literature reports that the most common sites for metastases are the liver, lung, lymph nodes, and bone. Extrathoracic disease is associated with a poor prognosis. The average time of survival after the diagnosis of metastases is 1.5 years. 相似文献
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《European journal of cancer (Oxford, England : 1990)》1999,35(3):433-437
Pilomatrix carcinoma, the malignant counterpart of pilomatrixoma, is rare, with only 55 cases reported, and only four cases with visceral metastases described in the literature. Here we present a case report and a literature review on this rare tumour. A 74-year-old male with a pilomatrix carcinoma from the left temporal region presented in July 1996 and the tumour was excised. One month after diagnosis, metastases to both lungs and to a regional lymph node were found and histologically verified. The patient also developed metastases in the abdomen, back and thoracic spine. The latter resulted in spinal cord compression and paraplegia. Despite systemic chemotherapy with intravenous cisplatin and 5-fluorouracil and localised radiotherapy to the thoracic spine, progression and deterioration led to death within 3 months from time of diagnosis. Pilomatrix carcinomas are usually indolent. In our patient, however, the malignant disease progressed rapidly and it appeared to be resistant to both chemotherapy and irradiation. 相似文献