摘要
In addition to hepatocellular carcinoma,metastatic liver cancer(MLC)is another focus of hepatic surgeon.Good outcome of patients with liver metastasis(LM)from colorectal cancer or neuroendocrine tumor have been achieved.Ovarian cancer liver metastasis(OCLM)has its unique oncological characteristics and a variety of metastasis patterns,which brings a challenge to hepatic surgeon.Hepatic surgeons hold different views and techniques from gynecologists,which makes differences in the evaluation and treatment of the disease.We reviewed recent studies and,in combination with our own clinical experience,attempted to introduce the progress of surgical treatment of liver metastases from OC.In our experience,both preoperative imaging and surgical procedures are based on the assurance of R0 resection.R0 cytoreductive surgery(CRS)is the most favorable determinant for the prognosis of OC patients,and R0 liver resection(LR)is a component of R0 CRS.Gynecologists and hepatic surgeons should do their own preoperative and intraoperative evaluation for the extrahepatic and intrahepatic metastasis respectively.During the operation,regardless of the miliary nodules dissemination between the right hemidiaphragm and liver capsule,liver parenchymal infiltration(LPI)or liver parenchymal metastasis(LPM),1–2 cm resection margin should be emphasized.For patients with liver portal lymph node metastasis(LPLNM),hepatic portal skeletonization should be performed,rather than portal lymph node dissection.The operation should be as radical as possible to ensure the patients to achieve good prognosis.
基金
This work was jointly supported by National Natural Science Foundation of China(81874182,81874056,81372314,81272393 and 81773266)
the National Key Project of China(2017ZX10203204-007-004)
the Public Health Bureau Foundation of Shanghai(201840019)
the Research Talent Foundation of Fudan University Shanghai Cancer Center(YJRC1604)
Key Disciplines Group Construction Project of Pudong Health Bureau of Shanghai(PWZxq2017-13).
