结直肠癌肝转移外科治疗的共识与争议

结直肠癌肝转移是导致结直肠癌患者死亡的主要原因。目前,循证医学证据表明手术切除是结直肠癌肝转移患者有效且可能获得长期生存的惟一治疗方式。随着外科技术尤其是微创外科技术的进步,越来越多的患者可从外科手术中获益。化学药物的发展以及贝伐单抗和西妥昔单抗等靶向药物的应用,使不可切除的结直肠癌肝转移转化为可切除,从而使更多患者获得治愈的机会。对于无法根治性切除的患者,外科手术联合射频治疗的方法可延长生存期。多学科合作团队诊治模式的广泛应用,使结直肠癌肝转移的治疗更加精准。

Consensus and controversy in surgical treatment for colorectal cancer with liver metastasis

Death from colorectal cancer is mainly due to liver metastasis. Surgical resection of liver metastasis is considered as the only curative treatment option for patients with colorectal cancer with liver metastases (CRLM). With the progress of surgical technique, especially the minimally invasive surgical techniques, more and more CRLM patients can benefit from surgery.With the development of systemic chemotherapy and the application of molecular targeted drugs (bevacizumab and cetuximab) in recent years, many CRLM patients can be converted from unresectable to resectable status. More patients with CRLM aquire the chance to be cured. Ablative techniques combined with surgery may be helpful for CRLM patients who cannot be treated with radical resection, to prolong life-span. The popular application of multidisciplinary team promotes the treatment of CRLM more precise.