PDF(Pubmed)
Abstract：
OBJECTIVE: This review addresses the current landscape of colorectal cancer (CRC) with a focus on liver metastases, the third most common cancer globally. It explores recent findings in treatment strategies, emphasizing the dynamic interplay between surgery, systemic chemotherapy, and local therapies for synchronous colorectal liver metastases (CRLMs).
RESULTS: Highlighting the role of advanced imaging, the review underscores the significance of contrast-enhanced MRI in surgical planning for CRLMs. Surgical resection remains a primary choice for resectable cases, with considerations for oncologic scoring systems and tumor biology. Perioperative systemic chemotherapy plays a pivotal role, especially in conversion therapy for initially unresectable CRLMs. The review also explores various local therapies, including radiofrequency ablation, microwave ablation, stereotactic body radiotherapy, hepatic arterial infusional chemotherapy, selective internal radiation therapy, and transarterial chemoembolization for unresectable cases. A comprehensive approach, integrating surgery, systemic chemotherapy, and local therapies, is crucial for managing synchronous CRLMs. Surgical resection and perioperative chemotherapy are key players, guided by considerations of tumor biology and scoring systems. For unresectable cases, local therapies offer viable alternatives, emphasizing the need for tailored treatments. Multidisciplinary collaboration among medical oncologists, surgeons, and radiologists is essential. Ongoing research will refine treatment approaches, while emerging technologies hold promise for further advancements in managing colorectal liver metastases.
RESULTS: Highlighting the role of advanced imaging, the review underscores the significance of contrast-enhanced MRI in surgical planning for CRLMs. Surgical resection remains a primary choice for resectable cases, with considerations for oncologic scoring systems and tumor biology. Perioperative systemic chemotherapy plays a pivotal role, especially in conversion therapy for initially unresectable CRLMs. The review also explores various local therapies, including radiofrequency ablation, microwave ablation, stereotactic body radiotherapy, hepatic arterial infusional chemotherapy, selective internal radiation therapy, and transarterial chemoembolization for unresectable cases. A comprehensive approach, integrating surgery, systemic chemotherapy, and local therapies, is crucial for managing synchronous CRLMs. Surgical resection and perioperative chemotherapy are key players, guided by considerations of tumor biology and scoring systems. For unresectable cases, local therapies offer viable alternatives, emphasizing the need for tailored treatments. Multidisciplinary collaboration among medical oncologists, surgeons, and radiologists is essential. Ongoing research will refine treatment approaches, while emerging technologies hold promise for further advancements in managing colorectal liver metastases.
摘要：
目的：这篇综述着眼于结直肠癌（CRC）的现状，重点是肝转移，全球第三大常见癌症。它探讨了治疗策略的最新发现，强调手术之间的动态相互作用，全身化疗,和同步结直肠癌肝转移（CRLM）的局部治疗。
结果：突出高级成像的作用，该综述强调了对比增强MRI在CRLMs手术计划中的重要性。手术切除仍然是可切除病例的主要选择，考虑肿瘤评分系统和肿瘤生物学。围手术期全身化疗起着举足轻重的作用,特别是在最初不可切除的CRLM的转换疗法中。该综述还探讨了各种局部疗法，包括射频消融,微波消融，立体定向身体放射治疗，肝动脉灌注化疗，选择性内部放射治疗，经肝动脉化疗栓塞治疗不可切除的病例。全面的方法，整合手术，全身化疗,和当地治疗，对于管理同步CRLM至关重要。手术切除和围手术期化疗是关键角色，以肿瘤生物学和评分系统的考虑为指导。对于不可切除的情况，当地疗法提供了可行的替代方案，强调需要量身定制的治疗方法。医学肿瘤学家之间的多学科合作，外科医生,放射科医生是必不可少的。正在进行的研究将改进治疗方法，而新兴技术有望在治疗结直肠癌肝转移方面取得进一步进展。
结果：突出高级成像的作用，该综述强调了对比增强MRI在CRLMs手术计划中的重要性。手术切除仍然是可切除病例的主要选择，考虑肿瘤评分系统和肿瘤生物学。围手术期全身化疗起着举足轻重的作用,特别是在最初不可切除的CRLM的转换疗法中。该综述还探讨了各种局部疗法，包括射频消融,微波消融，立体定向身体放射治疗，肝动脉灌注化疗，选择性内部放射治疗，经肝动脉化疗栓塞治疗不可切除的病例。全面的方法，整合手术，全身化疗,和当地治疗，对于管理同步CRLM至关重要。手术切除和围手术期化疗是关键角色，以肿瘤生物学和评分系统的考虑为指导。对于不可切除的情况，当地疗法提供了可行的替代方案，强调需要量身定制的治疗方法。医学肿瘤学家之间的多学科合作，外科医生,放射科医生是必不可少的。正在进行的研究将改进治疗方法，而新兴技术有望在治疗结直肠癌肝转移方面取得进一步进展。
