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本文对过去十年近1000例结肠直肠癌(CRC)肝转移瘤切除(HMR)进行回顾性分析。病人选择:估计今年将有147000例新的CRC被诊断,其中50％预计在5年内复发,研究表明约20％CRC复发病例最先或仅侵犯至肝,故将有约9000病人可能作肝切除术。肝外原发灶如为低分化腺癌可在肝外迅速发展,而在约1/3主要为肝转移的病人中,发现有肝外转移或肝内多发结节而无法手术切除。因而外科医师若严格地排除肝内多发性病灶及肝外转移灶的病例或只选择仅有肝或肺转移而生长缓慢的病例进行手术,则切除的效果便要好些。
This article reviews retrospectively 1000 cases of colorectal cancer (CRC) liver metastases (HMR) resection (HMR) over the past decade. Patient selection: It is estimated that 147,000 new CRCs will be diagnosed this year, 50% of which are expected to recur within 5 years. Studies show that about 20% of CRC relapse cases are the first or only to the liver, so there will be about 9000 patients who may undergo liver resection. Surgery. Extrahepatic primary lesions, such as poorly differentiated adenocarcinomas, can develop rapidly outside the liver, whereas in about one-third of patients with liver metastases, extrahepatic metastases or multiple nodules in the liver are found to be inoperable. Therefore, if the surgeon strictly excludes cases of intrahepatic multiple lesions and extrahepatic metastases or only selects cases with only slow liver or lung metastases for surgery, the effect of resection is better.