跳转到主要内容

No evidence from randomised clinical trials for optimal management of patients with large bowel cancer spread to lymph glands draining the liver

Nearly a third of patients with large bowel cancers (colorectal cancer) spread to the liver (liver metastases) within five years of diagnosis of bowel cancer. The affected part of the liver can be removed surgically in a quarter of such patients who develop liver spread from bowel cancer. About a seventh of these patients, in whom the affected part of the liver is suitable for removal, develop cancer involvement of lymph glands draining the liver (hepatic lymph node). Such patients are associated with poor survival even after removal of the affected part of the liver and the involved nodes. This Cochrane review attempted to answer the question of whether removing the part of the liver is better than other forms of treatment (such as no treatment, chemotherapy, heat destructive therapy using radiofrequency waves, ie, radiofrequency ablation) in such patients but did not find any randomised clinical trial addressing the issue. Currently, there is no evidence from randomised clinical trials for optimal management of these patients. High quality randomised clinical trials are feasible and are necessary to determine the optimal management of patients with colorectal liver metastases with hepatic node involvement.

研究背景

Involvement of hepatic lymph node in patients with colorectal liver metastases is associated with poor prognosis.

研究目的

To determine the benefits and harms of curative liver resection with lymphadenectomy versus other treatments for colorectal liver metastases with hepatic node involvement.

检索策略

We searched The Cochrane Hepato-Biliary Group Controlled Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library, MEDLINE, EMBASE, Science Citation Index Expanded, and LILACS until September 2009 for identifying the randomised trials.

纳入排除标准

We considered only randomised clinical trials (irrespective of language, blinding, or publication status) comparing liver resection (alone or in combination with radiofrequency ablation or cryoablation) versus other treatments (neo-adjuvant chemotherapy, chemotherapy, or radiofrequency ablation) in patients with colorectal liver metastases with hepatic node involvement.

资料收集与分析

Two authors independently identified trials for inclusion.

主要结果

We were unable to identify any randomised clinical trial fulfilling the inclusion criteria of this review. We were also unable to identify any quasi-randomised or cohort studies, which could meaningfully answer this important issue.

作者结论

There is no evidence in the literature to assess the role of surgery versus other treatments for patients with colorectal liver metastases with hepatic node involvement. High quality randomised clinical trials are feasible and are necessary to determine the optimal management of patients with colorectal liver metastases with hepatic node involvement.

引用文献
Gurusamy KS, Ramamoorthy R, Imber C, Davidson BR. Surgical resection versus non-surgical treatment for hepatic node positive patients with colorectal liver metastases. Cochrane Database of Systematic Reviews 2022, Issue 4. Art. No.: CD006797. DOI: 10.1002/14651858.CD006797.pub2.

我们的Cookie使用

我们使用必要的cookie来使我们的网站工作。我们还希望设置可选的分析cookie,以帮助我们进行改进。除非您启用它们,否则我们不会设置可选的cookie。使用此工具将在您的设备上设置一个cookie来记住您的偏好。您随时可以随时通过单击每个页面页脚中的“Cookies设置”链接来更改您的Cookie首选项。
有关我们使用cookie的更多详细信息,请参阅我们的Cookies页面

接受全部
配置