臨床外科71巻8号

2016年08月発行

特集 外科医が攻める高度進行大腸癌

両葉多発肝転移

著者： 大庭篤志¹ 光法雄介¹ 松村聡¹ 藍原有弘¹ 伴大輔¹ 落合高徳¹ 工藤篤¹ 安野正道² 石川敏昭³ 植竹宏之³ 田中真二⁴ 田邉稔¹

所属機関： ¹東京医科歯科大学肝胆膵外科学分野 ²東京医科歯科大学消化管外科学分野 ³東京医科歯科大学総合外科学分野 ⁴東京医科歯科大学分子腫瘍医学分野

ページ範囲：P.922 - P.930

文献概要

【ポイント】
◆切除可能肝転移の標準治療は肝切除である．ただし，予後の悪い“切除が適切でない”肝転移症例が存在し，治療成績改善に向けて周術期化学療法を組み合わせた臨床試験で検証されている．
◆切除不能大腸癌肝転移は全身化学療法の適応である．化学療法後に切除可能になり肝切除を行う（conversion chemotherapy）と，生存期間の延長が期待できる．
◆適応が拡大された肝転移手術でネックとなる残肝量不足の問題に対して，新しい計画的二期切除であるALPPSが注目されているが，合併症リスクなどの課題もある．

参考文献

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