晚期结直肠癌术前评估及治疗策略

Preoperative evaluation and treatment strategies for ad-vanced colorectai cancer

晚期结直肠癌主要分为局部晚期、术后局部复发及远处转移，远处转移主要包括腹膜转移及肝、肺等全身脏器的转移。手术切除是可能治愈晚期结直肠癌的惟一手段。术前以影像学评估为主，特别是对结直肠癌肝转移患者转移病灶可切除性的评估是外科治疗中尤其值得关注的问题。新辅助治疗及辅助治疗增加了晚期结直肠癌患者原发及转移病灶的手术切除率。近10年来，随着肿瘤外科的发展，多学科团队治疗模式的提出和实施，不仅使患者最大限度的受益，延长患者的生存时间，同时最大限度提高了患者的生命质量。

Advanced colorectal cancer mainly classi- fied as locally advanced, locally recurrent and distally metastatic colorectal cancer. Distal metastasis of colorectal cancer includes peritoneal metastasis, liver, lung and other organ metastasis. Surgical resection remains the only possible cure for patients with advanced colorectal cancer. Preoperative systemic evaluation based on radiographic images, especially the evaluation on the resectability of hepatic metastatic lesions from colorectal cancer is very important. Neo-adjuvant and adjuvant therapy increased the resection rate of primary and metastatic lesions of advanced colorectal cancer. In recent 10 years, with the development of oncological surgery, treatment modality of multi-disciplinary team has been proposed and implemented, which increased the survival time and improved the life quality of patients with color- ectal cancer.