In conceptu autem per Hellman oligometastasis propositus esset in MCMXCV. He pointed out that the lesion refers to some intermediate states between the localized growth of the tumor and systemic metastasis. Oligometastasis is organ-specific, but still does not have the ability to metastasize. It is at an early stage of tuberculum metastasis. The number and location of metastases Is limited. For these oligometastases, local treatment can be used to achieve disease control. Hellman believes that the state of oligometastasis may be related to tumor type, “seed cell” dissemination ability, stage and restriction ability of metastasis target organs.
There is no unified definition of the concept of oligometastasis. At present, oligometastasis is considered to be an intermediate state. Under this state, active and effective local treatment can achieve the purpose of disease control. The European Society of Medical Oncology (ESMO) 2016 consensus guidelines for the management of patients with metastatic colorectal cancer defined oligometastatic disease (OMD) as a disease state with ≤2 metastatic sites and ≤5 total metastases. There are three main types of oligometastasis in metastatic colorectal cancer (mCRC): simultaneous oligometastasis coexisting with the primary foci, metachronous oligometastasis that occurs after the primary foci are controlled, and induction after systemic system therapy Widow transfer. These three types of treatment may be different, and more clinical research and data are needed to explain.
Possibile mechanism et instituta oligotransfer
Non plene possit oligotransfer machina. Hoc tempore, sunt duo secrevi hypotheses circa progressionem ad systemica incrementum tumores ex locali metastasis. I hypothesi est "in prima sententia fata tumor." Hoc hypothesi oligometastasis credit quod sit, et multa alia metastatic phenotypes metastases. Clone incolarum tumore alio determinatur phenotypes metastatic hae duae et diversae potentiae metastatic. ; II hypothesi est 'progressus est a multi-oligo metastasis. " Et hoc est hypothesi medium tenet, ut oligo, metastasis ad statum morbo. Ex oligo metastasis ad-continua processus in qua multiple metastases est geneticae mutationes ludere magni momenti ordinatione, sed eius mechanism est magis in-profundum studium.
Determinare potest ad diversas curatio anorum versas hypotheses modi. Ex Hypothesi I, loci curatio potest in maius pondus et propositum est, sanitatem cum caedes probaretur. Ex Hypothesi II, systemica maius pondus Lorem habeat sequitur, et ex altiore salvos (OS). Bonum, ac minus Psidium curatio options sunt imbecillitate animi silere. Hoc tempore, qui tendunt praeferre hypothesi duo, sed una hypothesi etiam de causa eius. Vultus porro ut explicationes, quae ulterius sequuntur-sursum ad studium. Inquisitores et nonnulli deprehendi potest ad oligotransferring est interclusio et microRNA.
Consensus ESMO guidelines commendant tractationem finis oligometastasis esse status tumore-liberi (NED); principia curationis systemica includunt et curatio locali (chirurgica inclusa), et nucleus curationis optima est ratio curationis perioperativae. Ratio in luce ponit momentum "loci curationis perniciosae" in tractatione oligometastasis. Loci curationes non chirurgicae adhibitae includunt ablationem, arteriam transhepaticam, et theraphim radialem.
Chirurgicam curatio de oligometastasis colorectal cancer
Surgical treatment is the most commonly considered treatment method for oligometastasis of colorectal cancer (Table 1). Regardless of liver oligometastasis and lung oligometastasis, surgical treatment can produce significant OS benefits. Poor prognostic factors after hepatic oligometastasis include positive lymph nodes, elevated carcinoembryonic antigen (CEA) levels, tumor diameters greater than 10 cm, and positive margins. Factors related to the prognosis of lung oligometastasis include: CEA ≥5 ng / ml, tumor free interval (DFI) <36 months, number of lesions> 1, etc.
Nam oligometastasis et para-ostium lympha node (PALND) in colorectal cancer, si resection manu redditur, OS potest exinde ab adiunctis minus resection. De dissectione beneficia a Praecaventur oligometastasis in coxarum parte rectalis cancer lateat. Os oligometastasis Rectum est, sed medulla spinalis pressio oligometastasis sunt signa, ad beneficia de manu curandum esset, adhuc poterit esse videatur. Rectum enim cerebrum surgery est beneficium, quod combined per oligometastasis est obvious. Si ovarii oligometastasis sapientium disseminabunt seri non potest stare cum Hypothesi I, melior choice quod surgery est pro aegris sunt.
Colorectal cancer Rectum oligometastasis
Hoc tempore, surgery est pro prima oligometastasis arbitrium, sed magis significat esse necesse est, et sicut fons oligometastasis proposita et curatio. Prima differentia primae eiusdem foci et focis oligometastasis diversum targeting etiam aliquorum organorum. Non enim aliud sentiendi singularis facultas ad treatments, et non surgery treatment modum.
Cum renovatio technologiae alias quoque curationes habemus, ut radiotherapia, ablatio radiofrequentia, etc. Ad nonnulla oligometastasin consideranda oportet aegros dare minimum damnum. Radiotherapy stereotactica (SBRT) quaedam subsidia superstites afferre potest metastases iecoris et metastases pulmonis. Summus throughput SBRT singularia commoda in peroperativa et postoperativa complicationes super chirurgicam curationem habet. Ergo, radiotherapia est etiam bene tractatus bene pro oligometastasi (Tabula II). Licet sit finita in current notitia cum adhuc intellectus ad mechanism de oligometastasis, Rectum etiam potest curationem etiam reponere.
Ablationem radiofrequency pro colorectal cancer oligometastasis
Nam quaedam minima vitia cum radio frequency ablationem, utrum sit iecoris, pulmonis metastasis et metastasis, ablationem radiofrequency ostensum est commodi habet comparari manu curandum esset.
Oligotransfer justo summa ratione
In brevi, in colorectal cancer curatio oligometastasis necessitates in quadrigis plene aestimari a multidisciplinary (MST), et aegros cum status oligometastasis debet esse per opposita texit precise ac orci examen features. Nomina Systematica (systemica) est ex curatio, et ne loci curatio curatio potest considerari in ex systemic effective. In eodem tempore, in praemissa a loci curatio Tumor enim radicitus (R0) seu NED, ex in damnum loci curatio est minimized.
