Colorectal liver metastases: Current management and future perspectives  

作　　者：Jack Martin Angelica Petrillo Elizabeth C Smyth Nadeem Shaida Samir Khwaja HK Cheow Adam Duckworth Paula Heister Raaj Praseedom Asif Jah Anita Balakrishnan Simon Harper Siong Liau Vasilis Kosmoliaptsis Emmanuel Huguet 

机构地区：[1]Department of Surgery,Addenbrookes Hospital,NIHR Comprehensive Biomedical Research and Academic Health Sciences Centre,Cambridge University Hospitals NHS Foundation Trust,Cambridge CB20QQ,United Kingdom [2]Department of Precision Medicine,Division of Medical Oncology,University of Campania"L.Vanvitelli",Napoli 80131,Italy,&Medical Oncology Unit,Ospedale del Mare,80147 Napoli Italy [3]Department of Oncology,Addenbrookes Hospital,NIHR Comprehensive Biomedical Research and Academic Health Sciences Centre,Cambridge University Hospitals NHS Foundation Trust,Cambridge CB20QQ,United Kingdom [4]Department of Radiology,Addenbrookes Hospital,NIHR Comprehensive Biomedical Research and Academic Health Sciences Centre,Cambridge University Hospitals NHS Foundation Trust,Cambridge CB220QQ,United Kingdom [5]Department of Nuclear Medicine,Addenbrookes Hospital,NIHR Comprehensive Biomedical Research and Academic Health Sciences Centre,Cambridge University Hospitals NHS Foundation Trust,Cambridge CB20QQ,United Kingdom [6]Department of Pathology,Addenbrookes Hospital,NIHR Comprehensive Biomedical Research and Academic Health Sciences Centre,Cambridge University Hospitals NHS Foundation Trust,Cambridge CB20QQ,United Kingdom

出　　处：《World Journal of Clinical Oncology》2020年第10期761-808,共48页世界临床肿瘤学杂志（英文版）

摘　　要：The liver is the commonest site of metastatic disease for patients with colorectal cancer,with at least 25%developing colorectal liver metastases(CRLM)during the course of their illness.The management of CRLM has evolved into a complex field requiring input from experienced members of a multi-disciplinary team involving radiology(cross sectional,nuclear medicine and interventional),Oncology,Liver surgery,Colorectal surgery,and Histopathology.Patient management is based on assessment of sophisticated clinical,radiological and biomarker information.Despite incomplete evidence in this very heterogeneous patient group,maximising resection of CRLM using all available techniques remains a key objective and provides the best chance of long-term survival and cure.To this end,liver resection is maximised by the use of downsizing chemotherapy,optimisation of liver remnant by portal vein embolization,associating liver partition and portal vein ligation for staged hepatectomy,and combining resection with ablation,in the context of improvements in the functional assessment of the future remnant liver.Liver resection may safely be carried out laparoscopically or open,and synchronously with,or before,colorectal surgery in selected patients.For unresectable patients,treatment options including systemic chemotherapy,targeted biological agents,intraarterial infusion or bead delivered chemotherapy,tumour ablation,stereotactic radiotherapy,and selective internal radiotherapy contribute to improve survival and may convert initially unresectable patients to operability.Currently evolving areas include biomarker characterisation of tumours,the development of novel systemic agents targeting specific oncogenic pathways,and the potential reemergence of radical surgical options such as liver transplantation.

关 键 词：COLORECTAL CANCER LIVER METASTASES MANAGEMENT REVIEW 

分 类 号：R735.34[医药卫生—肿瘤]