消融治疗结直肠癌肝转移的研究进展

摘要/Abstract

摘要： 结直肠癌肝转移（CRLM）是结直肠癌患者死亡的主要原因之一,30%~50%的患者在病程中发生肝转移,其中仅约20%适合手术切除。影像引导下消融技术因其微创、安全及可重复等优势,已成为CRLM综合治疗的重要组成部分。本文就消融技术的临床应用、疗效影响因素、与手术切除的疗效比较及其在多模态综合治疗中的应用进行综述,并对未来发展方向进行展望。现有证据表明,对于严格筛选的肝寡转移患者,尤其是病灶直径<3 cm者,热消融在总生存方面不劣于手术切除,且不良事件发生率较低;对于部分不可切除、肝局限且病灶数有限的患者,包括消融在内的积极局部治疗联合系统治疗可能改善长期生存。随着影像导航及人工智能等精准技术的发展,消融在CRLM综合管理中的临床价值有望得到进一步拓展与验证。

关键词: 结直肠癌肝转移, 影像引导消融, 多模态治疗, 预后

Abstract: Colorectal liver metastases (CRLM) are a major cause of death in patients with colorectal cancer. Approximately 30%-50% of patients develop liver metastases during the disease course, and only about 20% are candidates for surgical resection. Image-guided ablation is minimally invasive and repeatable and has become an important component of the multidisciplinary management of CRLM. This review summarizes the clinical applications of ablation, factors influencing efficacy, comparisons with surgical resection, and its role in multimodal treatment, and discusses future directions. Current evidence suggests that, in carefully selected patients with oligometastatic liver disease, particularly those with lesions ≤3 cm, thermal ablation is non-inferior to surgical resection in terms of overall survival and is associated with a lower incidence of adverse events. In selected patients with unresectable, liver-limited disease and a limited number of metastases, adding aggressive local treatment, including ablation, to systemic therapy may improve long-term survival. Advances in image navigation and artificial intelligence may further expand and refine the role of ablation in CRLM management.

Key words: Colorectal liver metastases, Image-guided ablation, Multimodal therapy, Prognosis

姜彬彬, 武金玉, 吴薇. 消融治疗结直肠癌肝转移的研究进展[J]. 肝癌电子杂志, 2026, 13(3): 51-58.

Jiang Binbin, Wu Jingyu, Wu Wei. Advances in ablation therapy for colorectal liver metastases[J]. Electronic Journal of Liver Tumor, 2026, 13(3): 51-58.

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