Colorectal cancer (CRC) is the third most common cancer, and nearly half of CRC patients experience metastases. Oligometastatic CRC represents a distinct clinical state characterized by limited metastatic involvement, demonstrating a less aggressive nature and potentially improved survival with multidisciplinary treatment. However, the varied clinical scenarios giving rise to oligometastases necessitate a precise definition, considering primary tumor status and oncological factors, to optimize treatment strategies. This review delineates the concepts of oligometastatic CRC, encompassing oligo-recurrence, where the primary tumor is under control, resulting in a more favorable prognosis. A comprehensive examination of multidisciplinary treatment with local treatments and systemic therapy is provided. The overarching objective in managing oligometastatic CRC is the complete eradication of metastases, offering prospects of a cure. Essential to this management approach are local treatments, with surgical resection serving as the standard of care. Percutaneous ablation and stereotactic body radiotherapy present less invasive alternatives for lesions unsuitable for surgery, demonstrating efficacy in select cases. Perioperative systemic therapy, aiming to control micrometastatic disease and enhance local treatment effectiveness, has shown improvements in progression-free survival through clinical trials. However, the extension of overall survival remains variable. The review emphasizes the need for further prospective trials to establish a cohesive definition and an optimized treatment strategy for oligometastatic CRC.
结直肠癌是第三大常见恶性肿瘤，近半数患者会发生转移。寡转移性结直肠癌作为一种独特的临床状态，其特征是转移灶数量有限，侵袭性较低，通过多学科综合治疗可能改善患者生存。然而，由于导致寡转移的临床情境各异，需结合原发肿瘤状态及肿瘤学特征进行精确定义，以优化治疗策略。本文系统阐述了寡转移性结直肠癌的概念体系，包括原发灶控制良好的寡复发状态——此类患者往往预后更佳。文中全面探讨了局部治疗联合全身系统治疗的多学科综合治疗方案。寡转移性结直肠癌治疗的总体目标是通过完全清除转移灶实现临床治愈，其中局部治疗至关重要：手术切除是标准治疗方案，经皮消融和立体定向放射治疗则为无法手术的病灶提供了微创替代方案，在特定病例中显示出良好疗效。围手术期系统治疗旨在控制微转移病灶并增强局部治疗效果，临床试验已证实其可改善无进展生存期，但对总生存期的延长效果尚不一致。本综述强调需开展更多前瞻性临床试验，以建立统一的寡转移定义并优化治疗策略。
Optimizing Treatment Strategy for Oligometastases/Oligo-Recurrence of Colorectal Cancer
肿瘤(癌症)患者之家