为 colorectal 肝转移的外科: 决定的进化预后

• 作者: Gaya Spolverato Aslam Ejaz Nilo Azad Timothy M Pawlik
• 来源期刊: 世界胃肠肿瘤学杂志：英文版（电子版）
• 学科: 医学
• 关键词: COLORECTAL METASTASIS PROGNOSIS Risk SCORE Molecular MARKERS OUTCOMES
• 年，卷（期）: 2013,（12）
• 页码范围: 207-221
• 页数: 15页
• 分类号: R735.3

摘要

Despite improvements in the multi-modality treatment of colorectal liver metastasis (CRLM), survival after resection remains varied. Determining prognosis after surgical resection has historically been predicated on preoperative clinicopathological factors such as primary tumor stage, carcinoembryonic antigen levels, number of liver metastases, presence of extrahepatic disease, as well as other factors. While scoring systems have been developed by combining certain preoperative fac- tors, these have been inconsistent in accurately deter- mining prognosis. There has been increasing interest in the use of biologic and molecular markers to predict prognosis following CRLM. The role of markers such as KRAS, BRAF, p53, human telomerase reverse transcrip- tase, thymidylate synthase, Ki-67, and hypoxia inducible factor-1α and their correlation with accurately predict- ing survival after surgical resection have been sup- ported by several studies. Furthermore, other elements such as pathological response to chemotherapy and the presence of circulating tumor cells have shown promise in accurately determining prognosis after resection for colorectal liver metastasis.We herein review past, present, and possible future markers of prognosis among colorectal cancer patients with liver metastasis undergo-ing resection with curative intent.