转移性结直肠癌原发灶外科治疗策略  

Surgical management and strategy of primary tumor for metastatic colorectal cancer

作　　者：侯丁丁 赵力 HOU Dingding;ZHAO Li(Department of General Surgery,First Hospital of Tsinghua University,Beijing 100016,China)

机构地区：[1]清华大学第一附属医院普外科,北京100016

出　　处：《中国研究型医院》2021年第3期70-73,共4页Chinese Research Hospitals

基　　金：清华大学第一附属医院领航基金项目(LH-07)。

摘　　要：转移性结直肠癌(mCRC)行原发灶切除术的比例总体呈下降趋势。争议主要在对初始不可切除的mCRC无原发灶症状的患者行原发灶切除术(PTR)能否带来生存获益。全身治疗反应是肿瘤生物学行为的最佳筛选手段,筛选生物学行为好的患者可进行原发灶切除术,其手术时机与维持治疗开始的时机类似。原发灶切除术手术方式更趋向于腹腔镜下结直肠癌根治术,术中尽可能切除更多区域淋巴结,以便最大程度提高患者总生存期(OS),推测其机制可能与肿瘤免疫有关。The proportion of patients with metastatic colorectal cancer(mCRC)undergoing resection of the primary tumor showed an overall downward trend.The main controversy is whether primary tumor resection(PTR)can bring survival benefits to patients with initially unresectable mCRC without symptoms.Systemic response to treatment is the best screening method for tumor biological behavior.Patients with good biological behavior can be screened for primary tumor resection.The timing of surgery is similar to that of maintenance therapy.The surgical method of primary tumor resection tends to be laparoscopic radical resection of colorectal cancer.During the operation,as many regional lymph nodes are removed as possible to maximize the patient's overall survival(OS).It is speculated that the mechanism may be related to tumor immunity.

关 键 词：结直肠肿瘤 直肠结肠切除术 肿瘤治疗方案 

分 类 号：R735.34[医药卫生—肿瘤]