同时性结直肠癌肝转移的外科治疗策略

Surgical treatment strategies of synchronous colorectal cancer liver metastases

结直肠癌的发病率高居不下,其中20%以上的患者在诊断时即发现肝转移灶。同时性结直肠癌肝转移患者的肿瘤生物学行为较差,以外科为主的综合治疗可改善患者预后。但手术时机的选择、术前术后辅助性放化疗方案的制定等问题均无高级别证据给予定论,我们提倡多学科团队对患者进行全面评估,根据原发部位和肝内病灶的严重程度、是否引起症状及患者一般情况等因素综合制定个体化诊疗方案。

Colorectal cancer is among the most frequent malignancies world-wide,and more than 20% patients have synchronous liver metastases when diagnosed. These patients are associated with poor prognosis due to more aggressive tumor biological behavior. Comprehensive treatment plan including successful surgical resection of both primary and hepatic lesions can greatly improve longterm outcomes. However,the timing of surgery,administration of neoadjuvant and adjuvant chemotherapy,and some other related problems have not yet achieved any consensus. We suggest that every patient should undergo comprehensive work-up and be discussed by multidisciplinary team. Individualized treatment options should be made based on the severity of both primary and intrahepatic lesions,the presence of symptoms,and general condition of the patients.