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中华结直肠疾病电子杂志 ›› 2014, Vol. 03 ›› Issue (01) : 5 -8. doi: 10.3877/cma.j.issn.2095-3224.2014.01.02

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结直肠癌肝转移综合治疗进展
朱德祥1, 许剑民1,()   
  1. 1. 200032 上海,复旦大学附属中山医院普外科 复旦大学普通外科研究所 复旦大学大肠癌诊治中心
  • 收稿日期:2014-01-22 出版日期:2014-02-25
  • 通信作者: 许剑民
  • 基金资助:
    国家自然科学基金项目(81272390); 上海市卫生系统优秀学科带头人项目(XBR2011031); 上海市科技人才计划项目(12XD1401900)

Recent advances in the comprehensive treatment of colorectal liver metastases

De-xiang ZHU1, Jian-min XU1,()   

  1. 1. Department of General Surgery, Zhongshan Hospital, Fudan University; Institute of General Surgery, Fudan University; Colorectal Cancer Research Center, Fudan University, Shanghai 200032, China
  • Received:2014-01-22 Published:2014-02-25
  • Corresponding author: Jian-min XU
  • About author:
    Corresponding author: XU Jian-min, Email:
引用本文:

朱德祥, 许剑民. 结直肠癌肝转移综合治疗进展[J]. 中华结直肠疾病电子杂志, 2014, 03(01): 5-8.

De-xiang ZHU, Jian-min XU. Recent advances in the comprehensive treatment of colorectal liver metastases[J]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2014, 03(01): 5-8.

虽然手术仍是目前唯一有可能治愈结直肠癌肝转移的手段,但是在结直肠癌肝转移的诊疗方面发展迅速。多学科团队综合治疗和分组治疗逐渐成为诊疗规范。对可切除的结直肠癌肝转移患者,在围手术期也应实施标准化疗,是否加用靶向药物尚无定论。实施转化性化疗时应选择高效化疗方案,并尽量缩短疗程,且一旦转移灶转化为可切除,就应积极安排手术。肝转移灶不可切除的患者,是否切除原发灶也存在争议。在肝转移灶局部治疗方面的新技术发展迅速,可改善患者生存。

Although surgery is the only potentially curative method for colorectal liver metastases(CRLM), there are many advances in the treatments of CRLM.Multidisciplinary team and group therapy have become the standard treatments of CRLM.For patients with resectable CRLM, perioperative standard chemotherapy is necessary.However, whether the targeted therapy is needed to combined with is still inconclusive.Efficient chemotherapy regimen with short courses should be chosen for convertible therapy.And these patients should be operated as soon as the metastases become resectable.Resection of the primary tumor remains controversial in asymptomatic patients with unresectable CRLM.Some new locoregional therapies are developing fast to improve the survival.

[1]
Xu J, Qin X, Wang J,et al.Chinese guidelines for the diagnosis and comprehensive treatment of hepatic metastasis of colorectal cancer.J Cancer Res Clin Oncol,2011,137(9):1379-1396.
[2]
Jones R P, Vauthey J N, Adam R,et al.Effect of specialist decision-making on treatment strategies for colorectal liver metastases.Br J Surg,2012,99(9):1263-1269.
[3]
Schmoll H J, Van Cutsem E, Stein A,et al.ESMO Consensus Guidelines for management of patients with colon and rectal cancer.a personalized approach to clinical decision making.Ann Oncol,2012,23(10):2479-2516.
[4]
Power DG, Kemeny NE.Role of adjuvant therapy after resection of colorectal cancer liver metastases.J Clin Oncol,2010,28(13):2300-2309.
[5]
Nordlinger B, Sorbye H, Glimelius B,et al.Perioperative chemotherapy with FOLFOX4 and surgery versus surgery alone for resectable liver metastases from colorectal cancer(EORTC IntergrouP trial 40983):a randomised controlled trial.Lancet,2008,371(9617):1007-1016.
[6]
Primrose J, Falk S, Finch-Jones M,et al.Systemic chemotherapy with or without cetuximab in patients with resectable colorectal liver metastasis:the New EPOC randomised controlled trial.Lancet Oncol,2014,15(6):601-611.
[7]
Rong Z, Martel G, Vandenbroucke-Menu F,et al.Impact of peri-operative bevacizumab on survival in patients with resected colorectal liver metastases:an analysis of the LiverMetSurvey.HPB(Oxford),2014,16(4):342-349.
[8]
Chua TC, Saxena A, Liauw W,et al.Systematic review of randomized and nonrandomized trials of the clinical response and outcomes of neoadjuvant systemic chemotherapy for resectable colorectal liver metastases.Ann Surg Oncol,2010,17(2):492-501.
[9]
Nordlinger B, Van Cutsem E, Gruenberger T,et al.Combination of surgery and chemotherapy and the role of targeted agents in the treatment of patients with colorectal liver metastases:recommendations from an expert panel.Ann Oncol,2009,20(6):985-992.
[10]
Adam R, Bhangui P, Poston G,et al.Is perioperative chemotherapy useful for solitary,metachronous,colorectal liver metastases?.Ann Surg,2010,252(5):774-787.
[11]
Bischof DA, Clary BM, Maithel SK,et al.Surgical management of disappearing colorectal liver metastases.Br J Surg,2013,100(11):1414-1420.
[12]
Petrelli F, Barni S.Resectability and outcome with anti-EGFR agents in patients with KRAS wild-type colorectal liver-limited metastases:a meta-analysis.Int J Colorectal Dis,2012,27(8):997-1004.
[13]
Van Cutsem E,FolPrecht G,Bokemeyer C,et al.Chemotherapy plus cetuximab as conversion therapy for patients with initially unresectable colorectal cancer liver metastases.Amsterdam,the Netherlands:2013.
[14]
Falcone A, Ricci S, Brunetti I,et al.Phase III trial of infusional fluorouracil,leucovorin,oxaliplatin,and irinotecan(FOLFOXIRI)compared with infusional fluorouracil,leucovorin,and irinotecan(FOLFIRI)as first-line treatment for metastatic colorectal cancer:the Gruppo Oncologico Nord Ovest.J Clin Oncol,2007,25(13):1670-1676.
[15]
Tappenden P, Jones R, Paisley S,et al.Systematic review and economic evaluation of bevacizumab and cetuximab for the treatment of metastatic colorectal cancer.Health Technol Assess,2007,11(12):1-128.
[16]
Adam R, Haller DG, Poston G,et al.Toward optimized front-line therapeutic strategies in patients with metastatic colorectal cancer-an expert review from the International Congress on Anti-Cancer Treatment(ICACT)2009.Ann Oncol,2010,21(8):1579-1584.
[17]
Poultsides GA, Servais EL, Saltz LB,et al.Outcome of primary tumor in patients with synchronous stage IV colorectal cancer receiving combination chemotherapy without surgery as initial treatment.J Clin Oncol,2009,27(20):3379-3384.
[18]
Damjanov N, Weiss J, Haller DG.Resection of the primary colorectal cancer is not necessary in nonobstructed patients with metastatic disease.Oncologist,2009,14(10):963-969.
[19]
Aslam MI, Kelkar A, Sharpe D,et al.Ten years experience of managing the primary tumours in patients with stage IV colorectal cancers.Int J Surg,2010,8(4):305-313.
[20]
Stillwell AP, Buettner PG, Ho YH.Meta-analysis of survival of patients with stage IV colorectal cancer managed with surgical resection versus chemotherapy alone.World J Surg,2010,34(4):797-807.
[21]
Anwar S, Peter MB, Dent J,et al.Palliative excisional surgery for rimary colorectal cancer in atients with incurable metastatic disease.Is there a survival benefit? A systematic review.Colorectal Dis,2012,14(8):920-930.
[22]
Cirocchi R, Trastulli S, Boselli C,et al.Radiofrequency ablation in the treatment of liver metastases from colorectal cancer.Cochrane Database Syst Rev,2012,6:D6317.
[23]
Liang P, Wang Y, Yu X,et al.Malignant liver tumors:treatment with percutaneous microwave ablation-complications among cohort of 1136 patients.Radiology,2009,251(3):933-940.
[24]
Mocellin S, Pasquali S, Nitti D.Fluoropyrimidine-HAI(hepatic arterial infusion)versus systemic chemotherapy(SCT)for unresectable liver metastases from colorectal cancer.Cochrane Database Syst Rev,2009(3):D7823.
[25]
Ko YJ, Karanicolas PJ.Hepatic arterial infusion pump chemotherapy for colorectal liver metastases:an old technology in a new era.Curr Oncol,2014,21(1):e116-e121.
[26]
Xing M, Kooby DA, El-Rayes BF,et al.Locoregional therapies for metastatic colorectal carcinoma to the liver-An evidence-based review.J Surg Oncol,2014.doi:10.1002/jso.23619.
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