[Clinical research progress on disappearing colorectal liver metastases]

Zhonghua Wei Chang Wai Ke Za Zhi. 2021 Nov 25;24(11):1028-1034. doi: 10.3760/cma.j.cn441530-20201210-00657.
[Article in Chinese]

Abstract

Colorectal cancer is currently one of the most common digestive system tumors, and the liver is the most common metastatic site of colorectal cancer. In recent years, with the continuous development of the multidisciplinary treatment for colorectal cancer patients, there are quite a few cases of disappearing liver metastases (DLM) after receiving preoperative chemotherapy (or combined targeted drug therapy), and the diagnosis and treatment of DLM is currently still a very challenging and controversial topic. This article sorts out the related researches on DLM in recent years, mainly including the following 4 aspects: (1) The factors associated with DLM, including the size and number of liver metastases, chemotherapy regimens and cycles, targeted therapy drugs, and the pattern of liver metastases, Ras/Braf status and the location of the primary lesion. (2) The relationship between DLM and true complete response (pathological complete response and persistent clinical complete response), and the related predictive factors of pathological complete response. (3) Clinical evaluation of DLM: preoperative evaluation includes ultrasound, CT, MRI, and PET, while intraoperative evaluation includes intraoperative exploration, intraoperative ultrasound, and augmented reality. (4) DLM treatment strategies, including surgical treatment, local treatment, non-surgical treatment and individualized treatment.

结直肠癌是目前最常见的消化系统肿瘤之一,而肝脏是结直肠癌最常见的转移部位。近年来,随着结直肠癌患者多学科诊疗模式的不断发展,接受术前化疗(或联合靶向药物治疗)后出现肝转移灶消失(DLM)者不在少数,而DLM的诊断及治疗在当前仍然是一个颇具挑战及争议的话题。本文对近年来关于DLM的相关研究进行梳理,主要包括以下4个方面:(1)与DLM出现的相关因素,包括肝转移灶大小及数量、化疗方案和周期及靶向治疗药物、肝转移发生的模式、Ras/Braf状态及原发灶部位。(2)DLM与真正完全缓解(病理完全缓解和持续性临床完全缓解)的关系,以及与病理完全缓解发生的相关预测因素。(3)DLM的临床评估:术前评估包括超声、CT、MRI、PET,术中评估则包括术中探查、术中超声和增强现实。(4)DLM的治疗策略,包括手术治疗、局部治疗和非手术治疗及个体化治疗。.

Keywords: Colorectal neoplasms; Diagnosis; Disappearing liver metastases; Treatment.

MeSH terms

  • Colorectal Neoplasms*
  • Humans
  • Liver Neoplasms*
  • Magnetic Resonance Imaging
  • Ultrasonography