Karaciğer metastazı olan kolorektal kanserde cerrahi yaklaşım

Karaciğer en fazla metastazın olduğu organdır. Primer kolorektal kanser tanısı konulan hastaların yaklaşık %40'ında karaciğer metastazı gelişir. Bu hastalar tedavi edilmezse, ortalama yaşam 5-12 ay olmak üzere, fatal seyreder. Bu makalede kolorektal kanser kaynaklı karaciğer metastazlarının tedavisindeki son yıllardaki gelişmeler irdelenmiştir.

Surgical approach in hepatic metastases of colorectal cancer

Liver is an organ that harbors most of the metastases. Hepatic metastases were detected in %40 of the patients who had primary colorectal cancer. If these patients do not have any treatment, their survival will be between 5-12 months. In this review, popular treatment modalities in colorectal hepatic metastases were discussed.

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  • 1. Ballantyne GH, Quin J. Surgical treatment of liver metastases in patients with colorectal cancer. Cancer 1993; 71:4252-66.
  • 2. Jatzko G, Wette V, Muller M. Simultaneous resection of colorectal carcinoma and synchronous liver metastases in a district hospital. Int J Colorectal Dis 1991; 6:111-4.
  • 3. Schwartz SI: Liver, in Schwartz SI, Shires TG, Spencer FC, (eds): Principles of Surgery, 7th ed, p 1411. New York, McGraw Hill, 1999.
  • 4. Wagner JS, Adson MA, Van Heerden JA. The natural history of hepatic metastases from colorectal cancer. A comparison with resective treatment. Ann Surg 1984; 199:502-8,
  • 5. Fong Y, Cohen AM, Fortner JG, Enker WE, Turnbull AD, Coit DG, Marrero AM, Prasad M, Bluggart LH and Brennan MF. Liver resection for colorectal metastases. Journal of Clinical Oncology 1997; 15: 938-46,
  • 6. Bismuth H, Adam R, Levi F. Resection of nonresectable liver metastases from colorectal cancer after neoadjuvant chemotherapy. Ann Surg 1996; 224:509-20.
  • 7. Okuno K, Yasutomi M, Kon M. Intrahepatic interleukin-2 with chemotherapy for unresectable liver metastases: A randomized multicenter trial. Hepatogastroenterology 1999; 46:1116-21.
  • 8. Okuno K, Hirohata T, Nakamura K. Hepatic arterial infusions of interleukin-2-based immunochemotherapy in the treatment of unresectable liver metastases from colorectal cancer. Clin Ther 1993; 15: 672-83.
  • 9. Breedis C, Young G. The blood supply of neoplasms in the liver. Am J Pathol 1954; 30: 969-85.
  • 10. Ensminger WD, Gyves JW. Clinical pathology of hepatic arterial chemotherapy. Semin Oncol 1983; 10:176-82.
  • 11. Jarnagin WR, Bodniewicz, Dougherty E. A prospective analysis of staging laparoscopy in patients with primary and secondary hepatobiliary malignancies. J Gastrointest Surg 2000; 4: 34-43.
  • 12. Hughes K, Scheele J, Sugarbaker PH. Surgery for colorectal cancer metastatic to the liver. Optimizing the results of treatment. Surg Clin North Am 1989; 69: 39-359.
  • 13. Adson MA, Van Heerden JA, Adson MH. Resection of hepatic metastases from colorectal cancer. Arch Surg 1984; 119:647-51.
  • 14. Ohlsson B, Stenram U, Tranberg KG. Resection of colorectal liver metastases: 25-year experience. World J Surg 1998; 22:268-77.
  • 15. Fong Y, Fortner J, Sun RL, Brennan MF, Blumgart LH. Clinical score for predicting recurrence after hepatic resection for metastatic colorectal cancer. Analysis of 1001 consecutive cases. Ann Surg 1999; 230:309-21.
  • 16. Fong Y, Blumgart LH, Cohen A, Fortner J, Brennan MF. Repeat hepatic resections for metastatic colorectal cancer. Ann Surg. 1994; 220: 657-62.
  • 17. Couinaud C, Le Foie. Etudes Anatomiques et Chirurgicales. Paris, Masson, 1957.
  • 18. Pringle JB. Notes on arrest of hepatic hemorrhage due to trauma. Ann Surg 1908:48:541-9.
  • 19. Kwan Man, Sheung-Tat Fan, Irene O. L. Ng, Chung-Mau Lo, FRACS; Chi-Leung Liu, Wan-Ching Yu, MB; John Wong. Tolerance of the liver to intermittent Pringle Maneuver in hepatectomy for liver tumors. Arch Surg 1999; 134: 533-9.
  • 20. Man K, Fan ST, Ng I, Lo CM, Liu CL, Wong J. Prospective Evaluation of Pringle maneuver in Hepatectomy for Liver Tumors by a randomized Study. Ann Surg 1997; 226: 704-13.
  • 21. Hardy KJ, Tancheroen S, Shulkes A. Comparison of continuous versus intermittant ischaemia-reperfusion during liver resection in an experimental model. Br J Surg 1995; 82: 833-6.
  • 22. Belghiti J, Noun R, Malafosse R, Jagot P, Sauvanet A, Pierangeli F, Marty J, Farges O. Continuous versus intermittant portal triad clamping for liver resection: A controlled study. Ann Surg 1999; 229: 369-75.
  • 23. Uchinami M, Muraoka R, Horiuchi T. Effect of intermittent hepatic pedicle clamping on free radical generation in the rat liver. Surgery 1998; 124: 49-56.
  • 24. Horiuchi T, Muraoka R, Tabo T, Uchinami M, Kimura N, Tanigawa N. Optimal cycles of hepatic ischemia and reperfusion for intermittent pedicle clamping during liver surgery. Arch Surg 1995; 130: 754-8.
  • 25. Cheng-Chung Wu, Dah-Cherng Yeh, Wai-Meng Ho, Chu-Leng Yu, Shao-Bin Cheng, Tse-Jia Liu, Fang-Ku P’eng.: Occlusion of Hepatic Blood Inflow for Complex Central Liver Resections in Cirrhotic Patients. A Randomized Comparison of Hemihepatic and Hepatic Occlusion Techniques. Arch Surg 2002; 137:1369-76.
  • 26. Takayama T, Makuuchi M, Inoue K, Sakamoto Y , Kubota K, Harihara Y. Selective and unselective clamping in cirrhotic liver. Hepatogastroenterology 1998; 45: 376-80.
  • 27. Wu CC, Hwang CR, Liu TJ, P’eng FK. Effects and limitations of prolonged intermittent ischaemia for hepatic resection of the cirrhotic liver. Br J Surg 1996; 83; 121-4.
  • 28. Chang YC, and Nagasue N: Blocking intrahepatic inflow and backflow using Chang’s needle during hepatic resection: Chang’s maneuver. HPB 2008; 10: 244-248.
  • 29. Yamagata M, Matsumata T, Ikeda Y. Recurrence near the resection line of hepatocellular carcinoma in the anterosuperior subsequent of the liver—the effect of the argon beam coagulator. Hepatogastroenterology 1995; 42: 9-12.
  • 30. Chang YC, Nagasue N, Chen CS, Lin XZ. Simplified hepatic resections with the use of a chang’sneedle. Ann Surg 2006; 243:169-72.
  • 31. Kemeny N, Huang Y, Cohen AM. Hepatic arterial infusion of chemotherapy after resection of hepatic metastases from colorectal cancer. N Engl J Med 1999; 341: 2039-48.
  • 32. Kooby DA, Zakian KL, Challa SN. Use of phosphorus-31 nuclear magnetic resonance spectroscopy to determine safe timing of chemotherapy after hepatic resection. Cancer Res 2000; 60:3800-6.
  • 33. Panis Y, Ribeiro J, Chretien Y, Nordlinger B. Dormant liver metastases: an experimental study. Br. J. Surg 1992; 79: 221-3.
  • 34. Picardo A, Karpoff H, Ng B, Lee J, Brennan MF, Fong Y. Partial hepatectomy accelerates local tumor growth:potential roles of local cytokine activation. Surgery 1998; 124: 57-64.
  • 35. Jacob Ifabrikant . The kınetıcs of cellular proliferation in regenerating liver. Journal of Cell Biology 1968; 36 :551-65.
  • 36. Kooby DA, Zakian KL, Challa SN, Matei C, Petrowsky H, Yoo HH, Koutcher JA, Fong Y. Use of Phosphorous-31 Nuclear Magnetic Resonance Spectroscopy to Determine Safe Timing of Chemotherapy after Hepatic Resection. Cancer Research 2000; 60: 3800-6.
Cumhuriyet Tıp Dergisi (ELEKTRONİK)-Cover
  • Yayın Aralığı: Yılda 4 Sayı
  • Yayıncı: Cumhuriyet Üniversitesi Tıp Fakültesi
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