同时性结直肠癌肝转移的评分系统以及肝脏手术决策

Assessment tools and surgical treatment strategies of synchronous colorectal cancer liver metastasis

目前医疗卫生系统大力推进多学科会诊,同时性结直肠癌肝转移(sCRLM)的肝脏手术时机是专家讨论的重点,相同的sCRLM病例在不同的医院或者同一医院配比不同的专家,都有可能达成不同的治疗方案,一方面体现了多学科会诊的个体化诊疗特色,但另一方面也反映出目前sCRLM客观评估工具的缺失。本研究旨在对目前sCRLM常用评分工具作一综述,并探讨肝转移病灶同期、分期手术的最新临床报道与争议,以期对该领域的临床实践有所启发。

At present,the medical system vigorously promotes multidisciplinary diagnosis and treatment model(MDT),and the timing of liver surgery for synchronous colorectal cancer with liver metastasis(sCRLM)is the focus of expert discussion.The same sCRLM case in different hospital or the different experts is likely to be a different treatment.On the one hand,that reflects the individualized characteristics of MDT.But on the other hand,it also reflects the lack of objective evaluation tools in sCRLM.The purpose of this study is to review the commonly used scoring tools of sCRLM,and to discuss the controversies of simultaneous or staged surgery for liver metastases,so as to inspire the clinical practice in this field.