臨床外科65巻6号

2010年06月発行

特集 癌外科治療の日本と海外との相違点

大腸癌肝転移治療の日本と海外との相違点

著者： 田中邦哉¹ 遠藤格¹

所属機関： ¹横浜市立大学大学院医学研究科消化器・腫瘍外科

ページ範囲：P.796 - P.806

要旨：わが国では大腸癌自体が低率で原発性肝癌が高率であった事情を反映し，大腸癌肝転移に対する外科治療は海外に遅れをとってきた．現在でも，新規薬剤のドラッグラグといった問題により周術期化学療法も含め，海外データの追従に終始している印象がある．

　わが国の肝臓外科の高い技術レベルを駆使し，局所化学療法なども応用した集学的治療を展開して，オリジナリティのある臨床研究を行うことが独自のストラテジーの確立に重要である．このためにも大腸・肝臓外科医による積極的な多施設共同研究が必須であり，現在，肝胆膵外科学会ならびに大腸癌研究会が合同で，レトロスペクティブあるいはプロスペクティブな研究を企画中である．本領域におけるわが国発の海外へのエビデンスの発信が強く望まれる．

参考文献

1）Boyle P, Langman JS：ABC of colorectal cancer：Epidemiology. BMJ 321：805-808, 2000

2）Geoghegan JG, Scheele J：Treatment of colorectal liver metastases. Br J Surg 86：158-169, 1999

3）Weiss L, Grundmann E, Torhorst J, et al：Haematogenous metastatic patterns in colonic carcinoma：an analysis of 1541 necropsies. J Pathol 150：195-203, 1986

4）Scheele J, Stangl R, Altendorf-Hofmann A：Hepatic metastases from colorectal carcinoma：impact of surgical resection on the natural history. Br J Surg 77：1241-1246, 1990

5）Wade TP, Virgo KS, Li MJ, et al：Outcomes after detection of metastatic carcinoma of the colon and rectum in a national hospital system. J Am Coll Surg 182：353-361, 1996

6）Stucke K：Leberresektionen. Arch Klin Chir 284：629-641, 1956

7）Woodington GF, Waugh JM：Results of resection of metastatic tumors of the liver. Am J Surg 105：24-29, 1963

8）Wilson SM, Adson MA：Surgical treatment of hepatic metastases from colorectal cancers. Arch Surg 111：330-334, 1976

9）Foster JH：Survival after liver resection for secondary tumors. Am J Surg 135：389-394, 1978

10）Wanebo HJ, Semoglou C, Attiyeh F, et al：Surgical management of patients with primary operable colorectal cancer and synchronous liver metastases. Am J Surg 135：81-85, 1978

11）Morrow CE, Grage TB, Sutherland DE, et al：Hepatic resection for secondary neoplasms. Surgery 92：610-614, 1982

12）Fortner JG, Silva JS, Golbey RB, et al：Multivariate analysis of a personal series of 247 consecutive patients with liver metastases from colorectal cancer. Ⅰ. Treatment by hepatic resection. Ann Surg 199：306-316, 1984

13）Ekberg H, Tranberg KG, Andersson R, et al：Determinants of survival in liver resection for colorectal secondaries. Br J Surg 73：727-731, 1986

14）Registry of Hepatic Metastases：Resection of the liver for colorectal carcinoma metastases：a multi-institutional study of indications for resection. Surgery 103：278-288, 1988

15）Logan SE, Meier SJ, Ramming KP, et al：Hepatic resection of metastatic colorectal carcinoma：a ten-year experience. Arch Surg 117：25-28, 1982

16）Nordlinger B, Qailichini MA, Parc R, et al：Hepatic resection for colorectal liver metastases. Influence on survival of preoperative factors and surgery for recurrence in 80 patients. Ann Surg 205：256-263, 1987

17）Vauthey JN, Chaoui A, Do KA, et al：Standardized measurement of the future liver remnant prior to extended liver resection：methodology and clinical associations. Surgery 127：512-519, 2000

18）Azoulay D, Castaing D, Smail A, et al：Resection of nonresectable liver metastases from colorectal cancer after percutaneous portal vein embolization. Ann Surg 231：480-486, 2000

19）Adam R, Delvart V, Pascal G, et al：Rescue surgery for unresectable colorectal liver metastases downstaged by chemotherapy：a model to predict long-term survival. Ann Surg 240：644-658, 2004

20）Yamamoto J, Shimada K, Kosuge T, et al：Factors influencing survival of patients undergoing hepatectomy for colorectal metastases. Br J Surg 86：332-337, 1999

21）Tanaka K, Shimada H, Miura M, et al：Metastatic tumor doubling time：most important prehepatectomy predictor of survival and nonrecurrence of hepatic colorectal cancer metastasis. World J Surg 28：263-270, 2004

22）Cady B, Jenkins RL, Steele GD Jr, et al：Surgical margin in hepatic resection for colorectal metastasis：a critical and improvable determinant of outcome. Ann Surg 227：566-571, 1998

23）Fuhrman GM, Curley SA, Hohn DC, et al：Improved survival after resection of colorectal liver metastases. Ann Surg Oncol 2：537-541, 1995

24）Pawlik TM, Scoggins CR, Zorzi D, et al：Effect of surgical margin status on survival and site of recurrence after hepatic resection for colorectal metastases. Ann Surg 241：715-722, 2005

25）Kokudo N, Miki Y, Sugai S, et al：Genetic and histological assessment of surgical margins in resected liver metastases from colorectal carcinoma：minimum surgical margins for successful resection. Arch Surg 137：833-840, 2002

26）Altendorf-Hofmann A, Scheele J：A critical review of the major indicators of prognosis after resection of hepatic metastases from colorectal carcinoma. Surg Oncol Clin N Am 12：165-192, 2003

27）Gayowski TJ, Iwatsuki S, Madariaga JR, et al：Experience in hepatic resection for metastatic colorectal cancer：analysis of clinical and pathologic risk factors. Surgery 116：703-711, 1994

28）Scheele J, Stang R, Altendorf-Hofmann A, et al：Resection of colorectal liver metastases. World J Surg 19：59-71, 1995

29）Fong Y, Cohen AM, Fortner JG, et al：Liver resection for colorectal metastases. J Clin Oncol 15：938-946, 1997

30）de Haas RJ, Wicherts DA, Flores E, et al：R1 resection by necessity for colorectal liver metastases：is it still a contraindication to surgery? Ann Surg 248：626-637, 2008

31）Minagawa M, Makuuchi M, Torzilli G, et al：Extension of the frontiers of surgical indications in the treatment of liver metastases from colorectal cancer：long-term results. Ann Surg 231：487-499, 2000

32）Scheele J, Stangl R, Altendorf-Hofmann A, et al：Indications of prognosis after hepatic resection for colorectal secondaries. Surgery 110：13-29, 1991

33）Hughes K, Scheele J, Sugarbaker PH：Surgery for colorectal cancer metastatic to the liver. Optimizing the results of treatment. Surg Clin North Am 69：339-359, 1989

34）DeMatteo RP, Palese C, Jarnagin WR, et al：Anatomic segmental hepatic resection is superior to wedge resection as an oncologic operation for colorectal liver metastases. J Gastrointest Surg 4：178-184, 2000

35）Nordlinger B, Guiguet M, Vaillant JC, et al：Surgical resection of colorectal carcinoma metastases to the liver：a prognostic scoring system to improve case selection, based on 1568 patients. Association Française de Chirurgie. Cancer 77：1254-1262, 1996

36）Kokudo N, Tada K, Seki M, et al：Anatomical major resection versus nonanatomical limited resection for liver metastases from colorectal carcinoma. Am J Surg 181：153-159, 2001

37）Tanaka K, Shimada H, Matsumoto C, et al：Impact of the degree of liver resection on survival for patients with multiple liver metastases from colorectal cancer. World J Surg 32：2057-2069, 2008

38）Bismuth H, Castaing D, Traynor O：Surgery for synchronous hepatic metastases of colorectal cancer. Scand J Gastroenterol 149（Suppl）：144-149, 1988

39）Scheele J：Hepatectomy for liver metastases. Br J Surg 80：274-276, 1993

40）Lambert LA, Colacchio TA, Barth RJ Jr：Interval hepatic resection of colorectal metastases improves patient selection. Arch Surg 135：473-480, 2000

41）Yoshidome H, Kimura F, Shimizu H, et al：Interval period tumor progression：does delayed hepatectomy detect occult metastases in synchronous colorectal liver metastases? J Gastrointest Surg 12：1391-1398, 2008

42）Tanaka K, Shimada H, Matsuo K, et al：Outcome after simultaneous colorectal and hepatic resection for colorectal cancer with synchronous metastase. Surgery 136：650-659, 2004

43）de Santibañes E, Lassalle FB, McCormack L, et al：Simultaneous colorectal and hepatic resections for colorectal cancer：postoperative and longterm outcomes. J Am Coll Surg 195：196-202, 2002

44）Weber JC, Bachellier P, Oussoultzoglou E, et al：Simultaneous resection of colorectal primary tumour and synchronous liver metastases. Br J Surg 90：956-962, 2003

45）Benoist S, Pautrat K, Mitry E, et al：Treatment strategy for patients with colorectal cancer and synchronous irresectable liver metastases. Br J Surg 92：1155-1160, 2005

46）Rodgers MS, McCall JL：Surgery for colorectal liver metastases with hepatic lymph node involvement：a systematic review. Br J Surg 87：1142-1155, 2000

47）Nakamura S, Yokoi Y, Suzuki S, et al：Results of extensive surgery for liver metastases in colorectal carcinoma. Br J Surg ；79：35-38, 1992

48）Elias D, Ouellet JF, Bellon N, et al：Extrahepatic disease does not contraindicate hepatectomy for colorectal liver metastases. Br J Surg 90：567-574, 2003

49）Jaeck D, Nakano H, Bachellier P, et al：Significance of hepatic pedicle lymph node involvement in patients with colorectal liver metastases：a prospective study. Ann Surg Oncol 9：430-438, 2002

50）Oussoultzoglou E, Romain B, Panaro F, et al：Long-term survival after liver resection for colorectal liver metastases in patients with hepatic pedicle lymph nodes involvement in the era of new chemotherapy regimens. Ann Surg 249：879-886, 2009

51）Adam R, de Haas RJ, Wicherts DA, et al：Is hepatic resection justified after chemotherapy in patients with colorectal liver metastases and lymph node involvement? J Clin Oncol 26：3672-3680, 2008

52）Ambiru S, Miyazaki M, Isono T, et al：Hepatic resection for colorectal metastases：analysis of prognostic factors. Dis Colon Rectum 42：632-639, 1999

53）Kokudo N, Sato T, Seki M, et al：Hepatic lymph node involvement in resected cases of liver metastases from colorectal cancer. Dis Colon Rectum 42：1285-1291, 1999

54）Hur H, Ko YT, Min BS, et al：Comparative study of resection and radiofrequency ablation in the treatment of solitary colorectal liver metastases. Am J Surg 197：728-736, 2009

55）Abdalla EK, Vauthey JN, Ellis LM, et al：Recurrence and outcome following hepatic resection, radiofrequency ablation, and combined resection/ablation for colorectal liver metastases. Ann Surg 239：818-827, 2004

56）Pawlik TM, Izzo F, Cohen DS, et al：Combined resection and radiofrequency ablation for advanced hepatic malignancies：Results in 172 patients. Ann Surg Oncol 10：1059-1069, 20042003

57）Finlay IG, Seifert JK, Stewart GJ, et al：Resection with cryotherapy of colorectal hepatic metastases has the same survival as hepatic resection alone. Eur J Surg Oncol 26：199-202, 2000

58）Tanaka K, Shimada H, Nagano Y, et al：Outcome after hepatic resection versus combined resection and microwave ablation for multiple bilobar colorectal metastases to the liver. Surgery 139：263-273, 2006

59）Kornprat P, Jarnagin WR, DeMatteo RP, et al：Role of intraoperative thermoablation combined with resection in the treatment of hepatic metastasis from colorectal cancer. Arch Surg 142：1087-1092, 2007

60）Bismuth H, Adam R, Lévi F, et al：Resection of nonresectable liver metastases from colorectal cancer after neoadjuvant chemotherapy. Ann Surg 224：509-522, 1996

61）Tanaka K, Adam R, Shimada H, et al：Role of neoadjuvant chemotherapy in the treatment of multiple colorectal metastases to the liver. Br J Surg 90：963-969, 2003

62）Nordlinger B, Sorbye H, Glimelius B, et al：Perioperative chemotherapy with FOLFOX4 and surgery versus surgery alone for resectable liver metastases from colorectal cancer（EORTC Intergroup trial 40983）：a randomised controlled trial. Lancet 371：1007-1016, 2008

63）Allen PJ, Kemeny N, Jarnagin W, et al：Importance of response to neoadjuvant chemotherapy in patients undergoing resection of synchronous colorectal liver metastases. J Gastrointest Surg 7：109-117, 2003

64）Adam R, Pascal G, Castaing D, et al：Tumor progression while on chemotherapy. A contraindication to liver resection for multiple colorectal metastases? Ann Surg 240：1052-1064, 2004

65）Folprecht G, Grothey A, Alberts S, et al：Neoadjuvant treatment of unresectable colorectal liver metastases：correlation between tumour response and resection rates. Ann Oncol 16：1311-1319, 2005

66）Abdalla EK, Hicks ME, Vauthey JN：Portal vein embolization：rationale, technique and future prospects. Br J Surg 88：165-175, 2001

67）Oussoultzoglou E, Bachellier P, Rosso E, et al：Right portal vein embolization before right hepatectomy for unilobar colorectal liver metastases reduces the intrahepatic recurrence rate. Ann Surg 244：71-79, 2006

68）Covey AM, Brown KT, Jarnagin WR, et al：Combined portal vein embolization and neoadjuvant chemotherapy as a treatment strategy for resectable hepatic colorectal metastases. Ann Surg 247：451-455, 2008

69）Tanaka K, Kumamoto T, Matsuyama R, et al：Influence of chemotherapy on liver regeneration induced by portal vein embolization or first hepatectomy of a staged procedure for colorectal liver metastases. J Gastrointest Surg 14：359-368, 2009

70）Adam R, Laurent A, Azoulay D, et al：Two-stage hepatectomy：A planned strategy to treat irresectable liver tumors. Ann Surg 232：777-785, 2000

71）Tanaka K, Shimada H, Matsuo K, et al：Remnant liver regeneration after two-stage hepatectomy for multiple bilobar colorectal metastases. Eur J Surg Oncol 33：329-335, 2007

72）Miyazaki M, Ito H, Nakagawa K, et al：Aggressive surgical resection for hepatic metastases involving the inferior vena cava. Am J Surg 177：294-298, 1999

73）Aoki T, Sugawara Y, Imamura H, et al：Hepatic resection with reconstruction of the inferior vena cava or hepatic venous confluence for metastatic liver tumor from colorectal cancer. J Am Coll Surg 198：366-372, 2004

74）Tanaka K, Matsuyama R, Takeda K, et al：Aggressive liver resection including major-vessel resection for colorectal liver metastases. World J Hepatol 1：79-89, 2009

Howell SB（ed）；Intra-arterial and Intracavitary Cancer Chemotherapy. Boston, Martinus Nijhoff Publishers, pp1-10, 1984

76）Kemeny NE, Niedzwiecki D, Hollis DR, et al：Hepatic arterial infusion versus systemic therapy for hepatic metastases from colorectal cancer：a randomized trial of efficacy, quality of life, and molecular markers（CALGB 9481）. J Clin Oncol 24：1395-1403, 2006

77）Kemeny N, Gonen M, Sullivan D, et al：Phase Ⅰ study of hepatic arterial infusion of floxuridine and dexamethasone with systemic irinotecan for unresectable hepatic metastases from colorectal cancer. J Clin Oncol 19：2687-2895, 2001

78）Clavien PA, Selzner N, Morse M, et al：Downstaging of hepatocellular carcinoma and liver metastases from colorectal cancer by selective intra-arterial chemotherapy. Surgery 131：433-442, 2002

79）Ducreux M, Ychou M, Laplanche A, et al：Hepatic arterial oxaliplatin infusion plus intravenous chemotherapy in colorectal cancer with inoperable hepatic metastases：a trial of the gastrointestinal group of the Federation Nationale des Centres de Lutte Contre le Cancer. J Clin Oncol 23：4881-4887, 2005

80）Noda M, Yanagi H, Yoshikawa R, et al：Second-look hepatectomy after pharmacokinetic modulating chemotherapy（PMC）combination with hepatic arterial 5FU infusion and oral UFT in patients with unresectable hepatic colorectal metastases. J Clin Oncol 22（14s）：abstr 3739, 2004

81）Leonard GD, Fong Y, Jarnagin W, et al：Liver resection after hepatic arterial infusion（HAI）plus systemic oxaliplatin（Oxal）combinations in pretreated patients with extensive unresectable colorectal liver metastases. J Clin Oncol 22（14s）：abstr 3542, 2004

82）Kemeny N, Jarnagin W, Paty P, et al：Phase Ⅰ trial of systemic oxaliplatin combination chemotherapy with hepatic arterial infusion in patients with unresectable liver metastases from colorectal cancer. J Clin Oncol 23：4888-4896, 2005

83）Kemeny MM, Adak S, Gray B, et al：Combined-modality treatment for resectable metastatic colorectal carcinoma to the liver：surgical resection of hepatic metastases in combination with continuous infusion of chemotherapy―an intergroup study. J Clin Oncol 20：1499-1505, 2002

84）Kemeny N, Huang Y, Cohen AM, et al：Hepatic arterial infusion of chemotherapy after resection of hepatic metastases from colorectal cancer. N Engl J Med 341：2039-2048, 1999

85）Alberts SR, Roh MS, Mahoney MR, et al：Alternating systemic and hepatic artery infusion therapy for resected liver metastases from colorectal cancer：a north central cancer treatment group（NCCTG）/national surgical adjuvant breast and bowel project（NSABP）phase Ⅱ Intergroup Trial, N9945/CI-66. J Clin Oncol 28：853-858, 2010