关键词: 结直肠癌肝转移, 新辅助化疗, 肝动脉灌注, 切缘, 肺转移, 联合肝脏分隔和门静脉结扎的二步肝切除术

Abstract:

Main concerns in the treatment of colorectal liver metastases        XING Bao-cai. Hepatobiliary and Pancreatic Surgery Unit I, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital & Institute, Beijing 100142, China
Abstract    There are still many controversies in the treatment of colorectal liver metastases(CRLM) in spite of the presence of some randomized controlled trials. It seems that only patients with high risk will benefit from neoadjuvant chemotherapy. Hepatic arterial infusion (HAI) may become a useful method except for systemic chemotherapy for unresectable CRLM. R1 resection is also meaningful for patients who could not reach R0 resection. Synchronous unresectable lung metastases is not an absolute contraindication for performing liver resection. Associating liver partition with portal vein ligation for staged hepatectomy (ALPPS) offer a chance for unresectable CRLM but with high operative morbidity and mortality.

Key words: colorectal cancer liver metastases, neoadjuvant chemotherapy, hepatic arterial infusion, surgical margin, lung metastases, associating liver partition with portal vein ligation for staged hepatectomy (ALPPS)