结直肠癌肝转移的局部治疗:肝脏外科医师的机遇与挑战  

Local therapy of colorectal liver metastases:opportunities and challenges for hepatic surgeons

作　　者：邢宝才[1] 苏玉明 Xing Baocai;Su Yuming(Key Laboratory of Carcinogenesis and Translational Research(Ministry of Education),Hepatopancreatobiliary Surgery Department I,Peking University Cancer Hospital&Institute,Beijing 100142,China)

机构地区：[1]北京大学肿瘤医院暨北京市肿瘤防治研究所肝胆胰外一科,恶性肿瘤发病机制及转化研究教育部重点实验室,北京100142

出　　处：《中华消化外科杂志》2025年第2期173-177,共5页Chinese Journal of Digestive Surgery

基　　金：首都卫生发展科研专项首发重点攻关项目(2022‑1‑2151)。

摘　　要：我国国家癌症中心2022年癌症报告显示,结直肠癌年发病患者数51.71万(列第2位)、年死亡人数24.00万(列第4位),是目前严重威胁我国人民生命健康的疾病。与结直肠癌的不良预后及死亡密切相关的因素是结直肠癌肝转移。传统TNM分期中,肿瘤发生肝转移视为远处转移,归类为Ⅳ期肿瘤,预后通常较差。然而,结直肠癌肝转移与大多数肿瘤相比,有着特殊的生存特征。近30年的数据积累显示:结直肠癌肝转移的患者,采用系统治疗联合手术治疗,其5年生存率可为40%~50%;部分患者可以获得治愈。结直肠癌肝转移之所以可以获得如此好的长期生存,切除肝转移灶发挥非常重要的作用。随着结直肠癌发病率的增加,肝转移患者数量也在逐年增多。笔者认为:需要肝脏外科医师积极参与肝转移的多学科诊断与治疗中,根据不同情况,为肝转移患者提供规范化的个体化局部治疗。肝转移领域的诊断与治疗技术、治疗理念不断进步与更新,这还需要肝脏外科医师积极地面对困难,提高自己的知识水平,迎接挑战。According to the 2022 Cancer report of National Cancer Center,the annual incidence of colorectal cancer is 517,100(ranked second)and the annual mortality is 240,000(ranked fourth),making colorectal cancer a serious threat to people′s life and health in China.Colorectal liver metastasis is closely related to the poor prognosis and death of patients.In traditional TNM staging,the liver metastasis of tumor is considered as a distant metastasis status and is classified as a tumor of stageⅣ,which is related to poor prognosis.However,unlike most tumors,colorectal liver metastasis has its own special survival characteristics.The data accumulated in the last 30 years shows that the 5-year survival rate of patients with colorectal liver metastasis who underwent systematic treatment combined with surgery can reach 40%−50%,and some patients even can be cured.The resection of liver metastases for patients with colorectal liver metastasis plays a very important role in achieving such a good long-term survival.With the increasing incidence of colorectal cancer,the number of patients with colorectal liver metastasis is also increasing year by year.The authors believe that hepatic surgeons need to actively participate in the multidisciplinary team for diagnosis and treatment of colorectal liver metastasis,and provide standardized local treatment for patients with colorectal liver metastasis individualized.With the advancement of technology and the renewal of concept for diagnosis and treatment in the field of tumor liver metastasis,it is required that hepatic surgeons to actively face the progress of these treatments,enrich knowledge,and encounter challenges.

关 键 词：结直肠肿瘤 肝转移 局部治疗 诊断 治疗 

分 类 号：R73[医药卫生—肿瘤]