重视结直肠癌腹膜转移的合理诊断与治疗
Attaching importance to diagnosis and treatment of peritoneal metastases from colorectal cancer
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摘要:
结直肠癌腹膜转移通常被认为是结直肠癌的终末期病变,对患者预后及生命质量影响都较大。近年来,在全身控制基础上采用减瘤手术联合腹腔热灌注化疗治疗结直肠癌腹膜转移逐步被接受。但因设备缺乏、经验不足、手术复杂、并发症相对较多、占据医院资源较多等诸多原因其应用并未得到普遍推广。总体而言,对结直肠癌腹膜转移的重视程度仍存在不足。笔者认为:应当进一步重视对腹膜转移的机制研究,筛选高危患者并早期干预,减少腹膜转移的发生;选择对腹膜转移的敏感药物及干预途径,探索伴发其他远处转移的综合治疗模式,提高结直肠癌腹膜转移的治疗效果。
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关键词:
- 结肠肿瘤 /
- 直肠肿瘤 /
- 结直肠癌腹膜转移 /
- 减瘤手术联合腹腔热灌注化疗 /
- 个体化治疗
Abstract:Peritoneal metastasis from colorectal cancer (CRC) are generally considered to be end stage disease of CRC, which has greatly impacted the prognosis and quality of life of patients. In recent years, cytoreductive surgery and hyperthermic intraoperative intraperitoneal chemotherapy following systemic control has gradually been accepted for the treatment of peritoneal metastasis from CRC. Unfortunately, it has not widely used in clinical practice for the reasons of instruments, experience, surgical complexity, postoperative complications and costeffectiveness. There is still no sufficient importance attached to CRC with peritoneal metastasis. Researches on the mechanism and treatment of peritoneal metastasis should be encouraged. Screening of high risk patients for early intervention to reduce incidence of peritoneal metastasis, selecting effective regimens and exploring optimal model for patients with other distal metastasis to improve the outcome of patients may be of importance.
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