转移性肝癌的治疗理念和策略

转移性肝癌是恶性肿瘤发展的终末阶段，是导致患者死亡的主要原因，其中胃肠道是常见的原发癌部位。人们正尝试通过根治转移性肝癌或控制其发展等多种治疗策略，延长患者生存期。手术治疗、全身化疗、分子靶向治疗、射频消融术、门静脉栓塞术、肝动脉导管栓塞术是转移性肝癌的有效治疗方法，其中手术治疗是转移性肝癌可能获得治愈的有效手段。相比结肠癌肝转移癌，胃癌肝转移癌的治疗正处于探索阶段，但是随着新型有效化疗药物及化疗方案的出现、肝转移癌手术适应证的拓展以及大规模多中心临床试验循证医学证据的涌现，包括胃癌肝转移在内的转移性肝癌的治疗必将朝着一个更加规范，更为有效的方向发展。

Therapeutic concept and strategy of metastatic liver cancer

Metastatic hepatic cancer is the main cause of death of patients with malignant tumor at end stage. The gastroinetstinal tract is the most common primary site of metastatic tumor. Multiple therapeutic managements and strategies have been employed to control the progression of liver metastases and tried to gain the radical resection, so as to improve the prognosis of patients. Effective therapeutic managements include surgery, systemic chemotherapy, molecular targeted therapy, radiofrequency ablation, portal vein embolization and transarterial chemoembolization. However, surgical resection is the only curative treatment. Compared with liver metastasis of colorectal cancer, the treatment for liver metastasis of gastric cancer is still challenging. With the emergence of novel chemotherapeutics and regimens, wider indications of surgical resection in treating liver metastases and accumulated evidence from RCT, the therapeutic management of metastatic hepatic cancer should be standardized and more effective in the future.