CAJ | 학술논문

肝脏是结直肠癌最常见的转移部位,肝转移是结直肠癌治疗失败的主要原因.外科切除在结直肠癌肝转移综合治疗模式中占据主导地位,也是患者获得治愈机会的重要手段.尽管如此,在结直肠癌肝转移外科治疗领域目前还存在很多困惑和争议,包括结直肠癌肝转移分期系统尚不完善、潜在可切除标准尚未统一、可切除肝转移灶是否需要新辅助化疗、根治切除后辅助化疗方案的选择以及不可切除肝转移灶患者无症状原发灶的处理等.本文依据近年来发表的研究资料,结合自身临床实践,剖析肝转移外科研究领域中不同的观点和依据.
간장시결직장암최상견적전이부위,간전이시결직장암치료실패적주요원인.외과절제재결직장암간전이종합치료모식중점거주도지위,야시환자획득치유궤회적중요수단.진관여차,재결직장암간전이외과치료영역목전환존재흔다곤혹화쟁의,포괄결직장암간전이분기계통상불완선、잠재가절제표준상미통일、가절제간전이조시부수요신보조화료、근치절제후보조화료방안적선택이급불가절제간전이조환자무증상원발조적처리등.본문의거근년래발표적연구자료,결합자신림상실천,부석간전이외과연구영역중불동적관점화의거.
As the most common metastasis in colorectal cancer,liver metastasis is the primary cause of treatment failure.Resection plays a dominant role in multidisciplinary treatment of colorectal liver metastases.However,this surgical field is still filled with disputes and challenges.Literature on liver metastasis of colorectal cancer were reviewed and clinical trials were collected.Different opinions were analyzed according to clinical evidence and personal experience.There are many disputes about surgical treatment of colorectal liver metastases,including incomplete staging system,inconsistent criteria of potential resectability,neoadjuvant chemotherapy for resectable liver metastases,adjuvant chemotherapy regimen after radical resection,and treatment of asymptomatic primary lesion in patients with unresectable liver metastasis.