[1]潘凤,蔡萍,唐波,等.1例结肠癌肝转移患者多学科团队诊治与分析[J].第三军医大学学报,2019,41(10):974-979.
 PAN Feng,CAI Ping,TANG Bo,et al.Diagnosis and treatment of colonic cancer with synchronous liver metastases by a multidisciplinary team: a case report[J].J Third Mil Med Univ,2019,41(10):974-979.
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《第三军医大学学报》[ISSN:1000-5404/CN:51-1095/R]

卷:
41卷
期数:
2019年第10期
页码:
974-979
栏目:
临床医学
出版日期:
2019-05-30

文章信息/Info

Title:
Diagnosis and treatment of colonic cancer with synchronous liver metastases by a multidisciplinary team: a case report
作者:
潘凤蔡萍唐波王小军许森林李川高芬李建军
陆军军医大学(第三军医大学)第一附属医院:肿瘤科,结直肠癌MDT团队
Author(s):
PAN Feng CAI Ping TANG Bo WANG Xiaojun XU Senlin LI Chuan GAO Fen LI Jianjun

Department of Oncology, Multidisciplinary Team of Colorectal Cancer, First Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, 400038, China

关键词:
结肠癌肝转移多学科团队
Keywords:
colonic cancer liver metastases multidisciplinary team  
分类号:
R656.9;R735.3;R735.7
文献标志码:
A
摘要:

目的 探讨多学科团队(multidisciplinary team,MDT)在结直肠癌肝转移患者诊治过程中的作用。方法 应用MDT(包括放射科、病理科、普外科、肝胆科、肿瘤科、放疗科)讨论的方式,对1例结肠癌肝转移患者整个治疗过程的不同时期进行全面评估及确立治疗方案,采用多学科综合治疗手段使患者得到最大程度获益。结果 患者肝转移病灶潜在可切除,经转化治疗及多次多学科讨论后患者原发病灶及肝脏转移病灶接受手术及后续全身治疗,患者最终达到无瘤状态(no evidence of disease,NED),实现生存获益。结论 MDT模式可为结直肠癌患者找到最适合病情、多手段相结合、科学合理的诊疗方案,确保患者获得最佳治疗。

Abstract:

Objective To discuss the role of  a multidisciplinary team ( MDT) in the diagnosis and treatment of colorectal cancer with liver metastases. MethodsA MDT involving specialists from the departments of radiology, pathology, general surgery, hepatobiliary surgery, oncology and radiotherapy participated in the treatment planning and assessment throughout the treatment in a case of colonic cancer with liver metastases. The patient received comprehensive treatments provided by the MDT to maximize the treatment benefits. ResultsExamination of the patient showed that the metastatic foci in the liver were resectable. After translational treatment and several rounds of multidisciplinary discussions, the patient received surgical resection of the primary and metastatic lesions with postoperative systemic treatments. Follow-up of the patient showed no evidence of disease after chemotherapy, and survival benefits were achieved from the treatments. Conclusion The multidisciplinary approach is capable of providing the patients with colorectal cancer with specific, precise and individualized treatments to maximize the treatment benefits.

参考文献/References:

[1]BABA K, OSHITA A, KOHYAMA M, et al.Successful treatment of conversion chemotherapy for initially unresectable synchronous colorectal liver metastasis[J]. World J Gastroenterol, 2015, 21(6): 1982-1988. DOI: 10.3748/wjg.v21.i6.1982.
[2]NEEFF HP, DROGNITZ O, HOLZNER P, et al.Outcome after repeat resection of liver metastases from colorectal cancer[J]. Int J Colorectal Dis, 2013, 28(8): 1135-1141. DOI: 10.1007/s00384-013-1670-4.
[3]CHAN K M, WU T H, CHENG C H, et al. Prognostic significance of the number of tumors and aggressive surgical approach in colorectal cancer hepatic metastasis[J].World J Surg Oncol, 2014, 12(1):  155. DOI: 10.1186/1477-7819-12-155.
[4]PALKOVICS A, VERECAKEI A,  KALMAR K N, et al.The issue of survival after colorectal liver metastasis surgery:  parenchyma sparing vs. radicality[J]. Anticancer Res, 2018, 38(11): 6431-6438. DOI:  10.21873/anticanres.13004.
[5]DONATI O F,  HANY T F,  REINER C S, et al. Value of retrospective fusion of PET and MR images in detection of hepatic metastases: comparison with 18F-FDG PET/CT and Gd-EOB-DTPA-enhanced MRI[J]. J Nucl Med, 2010, 51(5): 692-699. DOI:  10.2967/jnumed.109.068510.
[6]DONATI F,  BORASCHI P,  PACCIARDI F, et al. 3T diffusion-weighted MRI in the response assessment of colorectal liver metastases after chemotherapy:  Correlation between ADC value and histological tumour regression grading[J]. Eur J Radiol, 2017, 91: 57-65. DOI:  10.1016/j.ejrad.2017.03.020.
[7]AL BANDAR M H, KIM N K.Current status and future perspectives on treatment of liver metastasis in colorectal cancer (review) [J].Oncol Rep, 2017, 37(5): 2553-2564. DOI: 10.3892/or.2017.5531.
[8]National Comprehensive Cancer Network. The NCCN colon cancer clinical practice guidelines in oncology(Version2.2016)[EB/OL].http: //www.nccn.org/professionals/physi-cian_gls/pdf/colon.pdf.
[9]TAN H L, LEE M, VELLAYAPPAN B A,  et al.The role of liver-directed therapy in metastatic colorectal cancer[J]. Curr Colorectal Cancer rep, 2018, 14(5): 129-137. DOI:  10.1007/s11888-018-0409-6.
[10]LEONARD G D,  BRENNER B,  KEMENY N E.Neoadjuvant chemotherapy before liver resection for patients with unresectable liver metastases from colorectal carcinoma[J]. J Clin Oncol,  2005, 23(9): 2038-2048. DOI: 10.1200/JCO.2005.00.349.
[11]MOHAMMAD WM, BALAA FK.Surgical management of colorectal liver metastases[J]. Clin Colon Rectal Surg, 2009, 22(4):  225-232. DOI: 10.1055/s-0029-1242462.
[12]NATHAN H,  DE JONG M C, PULITANO C, et al.Conditional survival after surgical resection of colorectal liver metastasis: an international multi-institution alanalysis of 949 patients[J]. J Am Coll Surg, 2010, 210(5): 755-766. DOI: 10.1016/j.jamcollsurg.2009.12.041
[13]CHAKEDIS J, SCHMIDT C R.Surgical treatment of metastatic colorectal cancer[J].Surg Oncol Clin N Am, 2018 , 27(2): 377-399. DOI:  10.1016/j.soc.2017.11.010.
[14]FLEISSIG A,  JENKINS V,  CATT S, et al. Multidisciplinary teams in cancer care:  are they effective in the UK? [J].Lancet Oncol, 2006, 7(11):  935-943. DOI: 10.1016/S1470-2045(06)70940-8.
[15]张忠涛, 蔡军.结肠癌多学科综合治疗协作组诊疗模式专家共识[J].中国实用外科杂志, 2017, 37(1): 44-45. DOI: 10.19538/j.cjps.issn1005-2208.2017.01.15.
ZHANG Z T,  CAI J. Expert consensus on diagnosis and treatment model for multidisplinary comprehensive treatment of colon cancer[J].Chin J Practical Surg, 2017, 37(1): 44-45. DOI: 10.19538/j.cjps.issn1005-2208.2017.01.15.
[16]中华医学会外科分会胃肠外科学组, 中华医学会外科分会结直肠外科学组, 中国抗癌协会大肠癌专业委员会, 等.中国结直肠癌肝转移诊断和综合治疗指南(V 2018) [J]. 中华结直肠疾病电子杂志, 2018, 7(4):  302-314. DOI: 10.3877/cma.j.issn.2095-3224.2018.04.001.
Department of Gastroenterology, Chinese Medical Association Colorectal Surgery, Chinese Cancer Society, Special Committee of Chinese Cancer Society. Chinese guideline for the diagnosis and comprehensive treatment of colorectal cancer liver metastasis (2018 Edition)[J]. Chin J Colorectal Dis (Electr Ed) , 2018, 7(4): 302-314. DOI: 10.3877/cma.j.issn.2095-3224.2018.04.001.
 

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更新日期/Last Update: 2019-05-24