老年結直腸癌肝轉移的治療_《中國普外基礎與臨床雜志》

作者：

賈昌俊 , 戴朝六

中國醫科大學附屬盛京醫院肝膽脾外科病房（遼寧沈陽 110004）;

關鍵詞：

老年結直腸癌肝轉移治療

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目的總結老年結直腸癌肝轉移（CRCLM）治療的現狀，探討老年CRCLM治療的方法和原則。方法復習國內、外近年來有關老年CRCLM治療的相關文獻并作綜述。結果結直腸癌是消化系統最常見的惡性腫瘤，而最常見的轉移部位是肝臟。近年來，老年結直腸癌發病率逐漸升高。雖然同年輕患者比較，老年CRCLM患者的身體狀態和生理機能較差，但只要選取合適的病例，同樣可以獲得與年輕患者相似的治療效果。目前，對于可切除的CRCLM患者，惟一可能治愈的手段仍然是外科手術治療; 而化療和分子靶向藥物治療的最新進展，也讓更多的老年患者生存獲益。對于不可切除的CRCLM病灶尚可結合其他肝臟導向的局部治療方法，如局部化療、消融治療等。結論根據CRCLM的發病特點和老年患者的自身特點，采用多學科協作模式下的個體化治療模式，可進一步提高老年CRCLM患者的綜合治療效果。

引用本文： 賈昌俊,戴朝六. 老年結直腸癌肝轉移的治療. 中國普外基礎與臨床雜志, 2011, 18(5): 485-493. doi: 復制

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16. Brand MI, Saclarides TJ, Dobson HD, et al. Liver resection for colorectal cancer: liver metastases in the aged [J]. Ann Surg, 2000, 66(4): 412415， discussion 415416.
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25. Bockhorn M, Sotiropoulos GC, Sgourakis G, et al. Major liver resections in the elderly-is an aggressive approach justified? [J]. Int J Colorectal Dis, 2009, 24(1): 8386.
26. Nojiri K, Nagano Y, Tanaka K, et al. Validity of hepatic resection of colorectal liver metastases in the elderly (75 years and older) [J]. Anticancer Res, 2009, 29(2): 583588.
27. Tamandl D, Gruenberger B, Herberger B, et al. Surgery after neoadjuvant chemotherapy for colorectal liver metastases is safe and feasible in elderly patients [J]. J Surg Oncol, 2009, 100(5): 364371.
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30. Reddy SK, Barbas AS, Turley RS, et al. Major liver resection in elderly patients: a multiinstitutional analysis [J]. J Am Coll Surg, 2011, 212(5): 787795.
31. 蔡三軍. 結直腸癌肝轉移的治療現狀 [J]. 中華胃腸外科雜志, 2009, 12(4): 430431.
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33. 涂玉亮, 焦華波, 譚向東, 等. 70歲以上老年患者結直腸癌肝轉移同步手術切除的臨床分析 [J]. 中國急救復蘇與災害醫學雜志, 2010, 5(8): 734736, 744.
34. Brouquet A, Abdalla EK, Kopetz S, et al. High survival rate after twostage resection of advanced colorectal liver metastases: responsebased selection and complete resection define outcome [J]. J Clin Oncol, 2011, 29(8): 10831090.
35. Wicherts DA, Miller R, de Haas RJ, et al. Longterm results of twostage hepatectomy for irresectable colorectal cancer liver metastases [J]. Ann Surg, 2008, 248(6): 9941005.
36. Karoui M, Viqano L, Goyer P, et al. Combined firststage hepatectomy and colorectal resection in a twostage hepatectomy strategy for bilobar synchronous liver metastases [J]. Br J Surg, 2010， 97(9): 13541362.
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《中國普外基礎與臨床雜志》

老年結直腸癌肝轉移的治療

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《中國普外基礎與臨床雜志》

老年結直腸癌肝轉移的治療

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