伴局限性肝转移的非小细胞肺癌手术治疗进展

Advance of surgery for non-small-cell lung cancer with limited liver metastases

作为发病率及死亡率最高的恶性肿瘤，3／4以上的肺癌在确诊时已处于中晚期，其中将近一半伴有胸外器官转移。既往认为这些患者不能直接通过手术获益。随着对恶性肿瘤寡转移状态自然病程的认识和分子生物学特征的研究，局部治疗手段的意义被逐步认可。新版TNM分期系统将远处器官的孤立转移状态重新定义为M1b期，既往不断有经手术治疗获得长期生存的报道。常见转移部位中，局限性脑、肾上腺、骨转移者，手术治疗证据较为明确。但同样发病率较高的肝转移，目前仍不明朗。现就非小细胞肺癌局限性肝转移行手术治疗的进展进行综述。

Objective Lung cancer has been the most common cause of cancer death worldwide. More than three quar- ters is diagnosed at advanced stage. Nearly one half has distant metastases outside the chest cavity. It has been recognized that oligometastatic state exists in natural history of malignant tumors, which has significantly better prognosis than those with poly- metastases. The eighth edition of TNM staging system defined NSCLC with a single metastasis as a new separated stage（Mlb）. Long - term survival of oligometastatic NSCLC patients treated with local control methods has been reported in literatures. But whether surgical resection of liver metastasis has benefit or not remains unknown. We performed a systematic review of surgical therapy for NSCLC with limited liver metastases.