Abstract:
Liver metastases are seen in at least 60% of patients with colorectal cancer at some point during the course of their disease. The management of both primary and liver disease is uniquely challenging in rectal cancer due to competing treatments and complex sequence of treatments depending on the clinical presentation of disease. Recently, several novel concepts are shaping new treatment paradigms, including changes in timing, sequence, and duration of therapies combined with potential deescalation of treatment components. Overall, the treatment of this clinical scenario mandates multidisciplinary evaluation and personalization of care; however, there is still considerable debate regarding the timing of liver metastasectomy in the context of the overall treatment plan. Herein, we will discuss the current literature on management of rectal cancer with synchronous liver metastasis, current treatment approaches with respect to chemotherapy, and role of hepatic artery infusion therapy.
摘要:
至少60%的结直肠癌患者在其病程中的某个时间点出现肝转移。由于取决于疾病的临床表现的竞争性治疗和复杂的治疗顺序,原发性和肝脏疾病的管理在直肠癌中具有独特的挑战性。最近,几个新颖的概念正在塑造新的治疗范式,包括时间的变化,序列,和治疗的持续时间以及治疗成分的潜在降级。总的来说,这种临床情景的治疗需要多学科评估和个性化护理;然而,在总体治疗计划的背景下,关于肝转移切除术的时机仍有相当多的争论.在这里,我们将讨论当前有关直肠癌同步肝转移治疗的文献,目前关于化疗的治疗方法,肝动脉灌注治疗的作用。