肝移植在不可切除结直肠癌肝转移中的应用综述
Liver transplantation in treatment of nonresectable colorectal cancer liver metastases
-
摘要: 结直肠癌(colorectal?cancer,CRC)是全球第三大癌症。15%左右的结直肠癌患者术后5年内会出现肝转移,肝切除术是效果较好的治疗方式,但只有20% ~ 40%的结直肠癌肝转移患者有机会接受肝切除术,无法行肝切除术的主要原因是残肝体积不足。通过门静脉栓塞术(portal veinembolization,PVE)、联合肝分割与门静脉支结扎的分步肝切除术(associating liver partition and portal vein ligation in staged hepatectomy,ALPPS)等术式可以提高肝转移瘤切除率,但总体切除率仍然低于50%。肝移植(liver transplantation,LT)对于无肝外受累的不可切除的结直肠癌肝转移患者是一个有吸引力的选择。近期研究表明,LT应用于不可切除结直肠癌肝转移患者的5年总体生存率为50%,结果十分乐观。本文旨在对LT应用于不可切除结直肠癌肝转移的研究现状进行综述。Abstract: Colorectal cancer (CRC) is the third most common cancer worldwide.?About 15% colorectal cancer patients will develop liver metastasis after surgery within 5 years, with liver resection serving as an effective treatment. However, only 20% to 40% patients with colorectal liver metastases are qualified for upfront liver resection. The reason for resection failure is that liver remnant volume in these patients is insufficient. The liver resection rate can be improved by portal vein embolization (PVE), associating liver partition and portal vein ligation in staged hepatectomy (ALPPS) and so on. However, the overall resection rate is still below 50%. Liver transplantation (LT) is an attractive option for patients with nonresectable CRC liver metastases without extra hepatic involvement. Recent studies have shown that the 5-year overall survival rate of LT in patients with nonresectable CRC liver metastases is 50%, which is very optimistic. This article aims to review the current research in LT for treatment of nonresectable CRC liver metastases.
下载: