Liver Metastasis: Current Concepts in Management and Future Perspectives

Sharma Aditya, Meena Ram Niwas, K. Anantha
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Abstract

Liver metastasis can be defined as the seeding of a malignant tumour from other organs affected by cancer. About half of the patients with colorectal cancer develop liver metastases during the progressive course of the disease. Surgery is the only curative treatment for patients with metastatic liver disease, and the five-year survival rate after resection of all detectable liver metastases can be as high as 40%. Unfortunately, only 25% of patients with liver metastases are candidates for liver resection. Regional treatments such as radiofrequency ablation and cryotherapy may be offered to patients with isolated, unresectable metastases but no evidence of extrahepatic disease. Chemotherapy and chemoembolization are often used in patients with liver metastases, but patients with extrahepatic disease are not suitable candidates for regional ablation. For patients with metastatic colorectal cancer beyond the liver, systemic chemotherapy is a better treatment option. Immunotherapy, when used with chemotherapeutic agents, has an additive therapeutic effect. More than half of the patients die of metastatic liver disease. Surgical resection of distant metastases can lead to prolonged survival and cure in a selected group of patients. This article reviews the current concepts along with recent advances and future perspectives in the management of patients with liver metastasis.
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肝转移:当前管理理念与未来展望
肝转移可定义为恶性肿瘤从其他受癌症影响的器官播种。大约一半的结直肠癌患者在疾病进展过程中会出现肝转移。手术是治愈转移性肝病患者的唯一治疗方法,切除所有可检测到的肝转移灶后,五年生存率可高达 40%。遗憾的是,只有 25% 的肝转移患者适合进行肝脏切除。对于孤立、无法切除转移灶但无肝外疾病证据的患者,可采用射频消融和冷冻疗法等区域性治疗。化疗和化疗栓塞通常用于肝转移患者,但肝外疾病患者不适合接受区域消融治疗。对于肝外转移性结直肠癌患者,全身化疗是更好的治疗选择。免疫疗法与化疗药物一起使用时,具有相加的治疗效果。一半以上的患者死于转移性肝病。对远处转移灶进行手术切除可延长部分患者的生存期并使其痊愈。本文回顾了治疗肝转移患者的现有概念、最新进展和未来展望。
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