간 전이를 동반한 대장암 치료의 최신지견

• Published in: The Korean journal of medicine Vol. 79; no. 2; pp. 125 - 132
• Main Authors: 남은미, Eun Mi Nam
• Format: Journal Article
• Language: Korean
• Published: 대한내과학회 01.08.2010
• Subjects: Colorectal cancer; Liver metastases; Liver resection; Neoadjuvant; Targeted agents; 간 전이; 간 절제술; 내과학; 대장암; 선행항암화학요법; 표적치료제
• ISSN: 1738-9364; 2289-0769

Colorectal cancer (CRC) is 2nd to 3rd common cancer and the annual incidence of CRC is increasing in Korea. The liver is the most frequent metastatic site of colorectal cancer and approximately one forth of patients presents with liver metastasis at initial diagnosis. Without treatment, patients with colorectal liver metastasis (CRLM) have a poor prognosis; however, long-term survival benefits and even cure have been reported in a portion of patients undergoing surgical resection of liver metastasis. In addition, advances in chemotherapeutic agents, imaging, and surgical techniques can increase the number of patients who are eligible for curative resection. In the past 10 years, combination chemotherapy with 5-fluorouracil (5-FU)/leucovorin (LV) and oxaliplatin or irinotecan was becoming the standard chemotherapy of treatment for metastatic CRC including CRLM. Furthermore, the combined use of targeted agents, such as cetuximab and bevacizumab, plus standard chemotherapeutics revealed more improvements in response rates and survival. Even in patients with resectable CRLM, perioperative chemotherapy with surgical resection could improve in progression free survival. However, the curable portion of patients with CRLM was still less than 20~30%, more detail management based on multidisciplinary team approaches should be needed. (Korean J Med 79:125-132, 2010)