- 期刊
Repeat Liver Resection for Recurrent Colorectal Metastasis
大腸直腸癌肝轉移復發後再次肝切除
摘要
在大腸直腸癌中，肝臟是最常轉移的位置。肝腫瘤切除提供一種可治癒的方式，經肝腫瘤切除的病人五年存活率可在40%到60%。但是一開始即診斷大腸癌乾轉移的病人只有20%到30%是一開始就可以開刀的。而即使在肝切除之後，大腸直腸癌復發的機率依然很高，其中有30%的人依然只有復發肝轉移。再切除肝腫瘤並不常見，但在一些謹慎評估過的病人身上，依然是可選擇的治療方式。我們報告的病例，一開始診斷大腸直腸癌時合併有肝轉移。經評估後認為無法完全手術切除。而在經過化學治療之後腫瘤縮小至可開刀的程度，進而接受肝切除手術，其在一年之內肝轉移復發，再次接受肝切除手術。術後恢復良好，至今未有其他復發的證據。我們回顧文獻認為在大腸直腸癌合併肝轉移的病人，若肝轉移是可切除的，皆應接受手術治療，以達治癒的目的。
並列摘要
The liver is the most common metastatic site of colorectal cancer. Hepatectomy is widely accepted as a treatment of potential cure and the 5-year survival rate is 40 to 60%. However, only 20 to 30% of patients have resectable disease initially. Even if hepatectomy can be performed, the chance of recurrence is still high throughout a patient's lifetime. About 30% of these recurrences are limited to the liver. Although repeat hepatectomy is not common, it can be considered in selected patients. Here, we report on a colorectal cancer patient initially diagnosed with unresectable liver metastasis. He underwent curative hepatectomy after chemotherapy, and received repeat hepatectomy after recurrent liver metastasis. Based on our case and review of the literature, we suggest that repeat hepatectomy is feasible in some selected patients with recurrent and resectable liver metastasis.
延伸閱讀
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- Chen, H. C., Chen, T. C., Hung, J. S., Huang, J., Lin, B. R., & Liang, J. T. (2020). 肝硬化病人接受腹腔鏡大腸直腸切除手術. 中華民國大腸直腸外科醫學會雜誌, 31(2), 75-80. https://doi.org/10.6312/SCRSTW.202006_31(2).10825