转移瘤不可切除的Ⅳ期结直肠癌行原发瘤切除的共识与争议  

Consensus and controversies in primary tumor resection for stageⅣcolorectal cancer with unresectable metastases

作　　者：陈功[1] 张荣欣[1] Chen Gong;Zhang Rongxin(Department of Colorectal Surgery,Sun Yat-Sen University Cancer Center,Guangzhou 510060,China)

机构地区：[1]中山大学肿瘤防治中心结直肠科,广州510060

出　　处：《中华消化外科杂志》2020年第9期1009-1012,共4页Chinese Journal of Digestive Surgery

基　　金：中山大学附属肿瘤医院临床研究项目308计划(2014⁃FXY⁃103)。

摘　　要：对于初始不可切除的转移性结直肠癌,是否行原发瘤切除既有共识,也有争议。有症状患者行原发瘤切除已成为共识。然而,对于无症状患者是否行预防性原发瘤切除仍存在较大争议。支持切除者认为:原发瘤切除能预防包括出血、穿孔、梗阻等并发症,为后续化疗创造条件。而反对者认为:术后恢复及可能带来的并发症将推迟全身化疗开始的时间,增加转移瘤进展风险。笔者结合国内外最新研究成果,从原发瘤与肠道并发症的关系以及原发瘤切除是否带来生存获益等方面进行综述,探讨转移瘤不可切除的Ⅳ期结直肠癌最佳的治疗模式。There are controversies and consensus in primary tumor resection(PTR)of colorectal cancer with unresec-table metastasis.PTR is required to palliate presenting symptoms.However,it remains controversial whether up-front PTR is effective for asymptomatic primary tumor.Favorers believe that PTR could prevent tumor-related complications such as bleeding,perforation,and bowel obstruction while create favorable conditions for subsequent chemotherapy.Opponents worry that post-operative recovery and complications would delay the timing of systemic chemotherapy thus increasing risk of disease progression.The authors discuss the correlation between presence of primary tumor and bowel complications and whether PTR brings survival benefits,in order to explore the best treatment strategy for stageⅣcolorectal cancer with unresectable metastases.

关 键 词：结直肠肿瘤 Ⅳ期 不可切除 原发瘤切除 共识 争议 

分 类 号：R735.34[医药卫生—肿瘤]