摘要
结直肠癌的发病率和死亡率位居全球癌症前列,而结直肠癌肝转移在结直肠癌根治术后极为常见。若不能手术切除,任何姑息性治疗都无法改变患者最终死亡的结局。小规模但经过充分随访的临床试验已经证实,肝移植治疗不可切除且无肝外病灶的结直肠癌肝转移(nonresectable liver-only colorectal liver metastases,nrCRLM)是可行且有效的,进一步推广nrCRLM肝移植的时机已经成熟,但在具体实施过程中仍需面临供体短缺、受体筛选以及高复发率等诸多挑战。本文拟针对结直肠癌肝转移不可切除性的判定、化疗相关肝损伤、nrCRLM肝移植预后因素、肝移植术式以及术后治疗方案等关键问题展开讨论,以期推动肝移植治疗nrCRLM高质量、规范化发展。
Colorectal cancer has been one of the leading malignancies with a high incidence and a great mortality in the world,Liver is the most common site of metastases.For nonresectable colorectal liver metastases(nrCRLM),no palliative therapy brings any change of terminal death.With limited sample sizes but long enough follow-ups,a series of clinical trials have confirmed that selected nrCRLM patients may be cured by liver transplantation(LT).However,there are great challenges of donor shortage,recipient criteria and high recurrence rate after LT.For promoting the curative effect and quality control,the authors elaborated upon various major issues of LT for nrCRLM,including non-resectability of colorectal liver metastases,chemotherapy-associated liver injuries,prognostic factors,surgical approaches and post-transplant therapies.
作者
滕飞
毛家玺
宋少华
傅志仁
Teng Fei;Mao Jiaxi;Song Shaohua;Fu Zhiren(Department of Organ Transplantation&Hepatic Surgery,Changzheng Hospital,Naval Medical University,Shanghai 200003,China;Department of General Surgery,Affiliated Ruijin Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200025,China)
出处
《中华器官移植杂志》
CAS
2023年第12期717-722,共6页
Chinese Journal of Organ Transplantation
基金
国家自然科学基金(82371792)。
关键词
结直肠癌
转移性肝癌
肝移植
肝切除
肝损伤
化学疗法
Colorectal cancer
Metastatic liver cancer
Liver transplantation
Hepatectomy
Liver injury
Chemotherapy
