【摘要】 手术切除是治疗结直肠癌肝转移的首选手段,而手术治疗仍存在较多须再探讨的问题。新建立的Basingstoke预测预后模型可为临床选择积极手术的病人提供量化依据。肝切缘距肿瘤<1 cm的根治性切除(R0)可能并不增加肝切除局部复发风险。结直肠癌原发灶与肝转移瘤同期切除已渐成共识,同期切除并不增加手术并发症发生率和手术死亡率。可切除的肝转移瘤行新辅助化疗可能无法提高总生存时间和无进展生存期,甚至可能使少数病人丧失手术切除机会。准确判断肝切除范围和术式可提高切除率,有可能进一步扩大肝切除适应证。更多还原

【Abstract】 Surgical resection is the major measure of colorectal liver metastases. However, several issues remain controversial. Newly established Basingstoke prediction index could offer quantized evidence for surgical candidates. Radical resection(R0) with margin less than 1cm would not increase local recurrence. It has become to consensus that simultaneous resection for both primary neoplasm and liver metastasis could be safe and could not increase morbidity or mortality.Neoadjuvant chemotherapy for patients with resectable liver metastases probably fails to improve the total survival or progression free survival. In factor,some patients may lost opportunities for surgical resection due to progression during chemotherapy. A precise prediction of resection extension and a proper surgical type could extend indications for the hepatectomies.更多还原