乳腺癌肝转移临床特点及外科治疗

Clinical characteristics and surgical treatment for breast cancer patients with liver metastases

肝脏转移是乳腺癌常见的远处转移方式之一,传统治疗方法效果欠佳,是重要的预后不良因素。局限性乳腺癌肝转移手术切除的远期效果较好,部分病人可获得长期存活。但尚缺乏大规模临床资料证据,须进一步规范手术适应证、手术方式选择和综合治疗方案等。经皮激光热疗和射频消融等介入治疗为乳腺癌肝转移病人提供了新的外科治疗选择,多适合较小的肝脏转移灶,其应用范围尚有局限性,亦缺乏相关的临床对照研究。乳腺癌肝转移(较大病灶和多发性病灶)的外科治疗正在积极探索中。外科治疗结合综合治疗有望进一步改善乳腺癌肝转移病人预后。

Liver is one of the common metastatic sites for breast cancer. Breast cancer patients with liver metastases （BCLM） are often insensitive to traditional therapy and have poor prognosis. Liver resection is generally adopted if the lesion is localized, which has made BCLM obtain a better outcome. However, it still need to be supported by more large-scale clinical data and evidence, especially for standard operation indication, method and combined modality therapy. Minimally invasive surgery, such as radio frequency ablation （RFA） and laser-induced interstitial thermotherapy （LITT）, could provide extra options for BCLM with small tumors, but both have some clinical limitations and still need further clinical study to confirm the curative effects. Surgical treatments for BCLM with comparatively large or nmhiple tumors are still under exploration. Systemic treatment combined with proper surgical process can improve BCLM prognosis.