结直肠癌肝转移围术期治疗决策

Perioperative treatment strategy for colorectal liver metastases

肝转移是结直肠癌患者死亡的主要原因.手术是目前治疗结直肠癌肝转移的最佳手段.然而,在围术期如何合理选择个体化的化疗方案以及手术时机和手术方式一直存在争议.因此,如何通过多学科团队模式对结直肠癌肝转移患者及其术前检查结果进行全面评估,针对不同的治疗目标,将患者分为不同组别,明确各组不同的治疗目的,为患者选择合理的化疗和靶向治疗方案,确定手术时机（是同步切除还是分步切除）和手术方式（是微创手术还是开腹手术）是提高结直肠癌肝转移患者预后的关键.

Liver metastasis is the leading cause of death from colorectal cancer.Surgical treatment is so far the best choice for the treatment of colorectal liver metastases （CRLM）.However,how to suitably select an individualized chemotherapy in perioperative period and surgical time and tool is still under controversy.Therefore,the key factors of improving the prognosis of patients with CRLM include overall evaluation of the patients and their preoperative examination outcomes,dividing patients into different groups based on different therapeutic goals,understanding different therapeutic goals of each group,selecting suitable chemotherapy and targeted therapy,ensuring surgical time （synchronous or stepwise resection） and tools （minimally invasive or open surgery） through multidisciplinary team model.