Guidelines for the detection and treatment of liver metastases of colorectal cancer
Guidelines for the detection and treatment of liver metastases of colorectal cancer
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DOI：
10.1007/s12094-007-0129-x
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发表时间：
2007-11-01
影响因子：
3.4
通讯作者：
Aranda, E.
中科院分区：
文献类型：
--
作者：
Abad, A.;Figueras, J.;Aranda, E.
肝转移癌外科治疗的推广对提高转移性结直肠癌的治疗水平和生存率至关重要。转移的早期和准确诊断及其大小的评估是使用这种治疗策略达到最佳结果的重要因素。手术技术的准确适应症（有或无既往新辅助化疗）对于R0手术的选择和干预时机具有重要意义。虽然目前对一些与诊断技术和手术标准相关的参数（如双叶延伸、手术切除后剩余肝脏的大小和术前化疗的适应证）存在一致意见，但有必要考虑所有这些因素以建立标准标准并优化结果。在这篇文章中，我们回顾了所有这些参数，从疾病随访到检测转移性播散，再到使用新辅助化疗的基本标准，以提出一些证据等级为II级和推荐等级为A级的一般建议。
The spread of the surgical treatment for hepatic metastases have been crucial in the improvement of treatment and survival of metastatic colorectal cancer. The early and accurate diagnosis of metastases and the assessment of their size are essential factors to reach the optimal results with this treatment strategy. The precise indication of the surgical technique with or without the previous administration of neoadjuvant chemotherapy is of significant importance for the choice of R0 surgery and the timing of intervention. Although there is an agreement regarding some parameters related to diagnosis techniques and surgical criteria such as the bilobar extension, the size of the remaining liver post-surgical removal and the indication of pre-operatory chemotherapy, it is necessary to consider all these factors to set up standard criteria and optimize the results. In this article we review all these parameters, from disease follow up to detect metastatic dissemination to the basic criteria for use of neoadjuvant chemotherapy, in order to suggest some general recommendations of evidence level II and recommendation grade A.