grekovВестник хирургии имени И.И. ГрековаGrekov's Bulletin of Surgery0042-46252686-7370Federal State Budgetary Educational Institution of Higher Education «Academician I.P. Pavlov First St. Petersburg State Medical University» of the Ministry of Healthcare of the Russion Federation, FSBEI HE I.P.Pavlov SPbSMU MOH Russia10.24884/0042-4625-2018-177-5-63-67grekov-1054Research ArticleОНКОХИРУРГИЯONCOSURGERYОбоснование принципов комбинированного этапного лечения больных раком толстой кишки с нерезектабельными метастазами в печеньSubstantiation of principles of combined stage treatment of patients with colon cancer with unresectable liver metastasesLinkK. Н.LinkK. H.

Link Karl-Heinrich - Prof. Dr. h.c., Senior Medical Advisor and Representative APK/ASK; Chief Medical Officer Broermann Research GmbH; Ehem. Direktor des Chirurgischen Zentrums APK; Ehem. Chefarzt der Abteilung Chir.I (Allgemein- und Viszeralchirurgie) APK.

Wiesbaden

k-h.link@asklepios.comМайстренкоН. А.MaistrenkoN. A.

Майстренко Николай Анатольевич - доктор медицинских наук, профессор, академик РАН, зав. кафедрой факультетской хирургии им. С. П. Фёдорова ВМедА им. С. М. Кирова.

194044, СанктПетербург, ул. Академика Лебедева, д. 6

St. Petersburg

nik.m.47@mail.ruTaoQ. S.TaoQ. S.KornmannМ.KornmannM.

Kornmann Marko  M. - D., Assistant Professor of Surgery; Vice Chair; Deparment of General und Visceral Surgery

zrwkpsy@163.comStaibL.StaibL.

Esslingen

LinkCh.LinkCh.

Wiesbaden

LiJ.-T.LiJ.-T.zjulijiangtao@163.comPengS. Y.PengS. Y.

Shu You Peng - Professor, Professor of Surgery, Department of Surgery, Second Affiliated Hospital

 

zrwkpsy@163.comJiZ. L.JiZ. L.RoitmanМ.RoitmanM.

Wiesbaden

BegerH. G.BegerH. G.Клиника Асклепия ПаулиныГерманияAsklepios Paulinen ClinicGermanyФедеральное государственное бюджетное военное образовательное учреждение высшего образования «Военно-медицинская академия имени С.М. Кирова» Министерства обороны Российской ФедерацииРоссияFederal State Budgetary Military Educational Institution of Higher Education «Military Medical Academy named after S.M. Kirov» of the Ministry of Defence of the Russian FederationRussian FederationЮжный университетКитайSoutheast UniversityChinaУльмский университетГерманияUlm UniversityGermanyГородская клиникаГерманияCity HospitalGermanyУниверситет ФландгоуКитайFlangzhou UniversityChina20182810201817756367Copyright © Link K.Н., Майстренко Н.А., Tao Q.S., Kornmann М., Staib L., Link C., Li J., Peng S.Y., Ji Z.L., Roitman М., Beger H.G., 20182018Link K.Н., Майстренко Н.А., Tao Q.S., Kornmann М., Staib L., Link C., Li J., Peng S.Y., Ji Z.L., Roitman М., Beger H.G.Link K.H., Maistrenko N.A., Tao Q.S., Kornmann M., Staib L., Link C., Li J., Peng S.Y., Ji Z.L., Roitman M., Beger H.G.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.vestnik-grekova.ru/jour/article/view/1054

Представлены результаты многолетних клинических, молекулярно-биологических и лабораторных исследований, посвященных комбинированному полиэтапному лечению больных раком толстой кишки с метастазами в печень. Изучена цитотоксичность различных химиопрепаратов на колоректальную карциному в линиях клеток НТ 29 и NМG 64/84 с помощью анализа колониеобразующей опухоли человека (HTCA). Выполнены исследования in vitro на взвеси опухолевых клеток из удаленных метастазов печени с целью определения наиболее эффективных химиопрепаратов для интраартериальной печеночной инфузии (HAI). Индивидуальный выбор схемы системной химиотерапии зависит от активности тимидилатсинтетазы (ТS) в опухолевой ткани. Многолетний собственный клинический опыт и анализ мировой литературы позволяют утверждать, что этапная резекция печени (STR) в сочетании с регионарной (HAI) и системной химиотерапией является методом выбора в лечении больных колоректальным раком с нерезектабельными метастазами в печени. По сравнению с другими методиками лечения (ALPPS и ТSH), STR имеет наименьшие негативные последствия и выгодна с опухолево-биологической точки зрения.

The article presents the results of long-term clinical, molecular-biological and laboratory studies on combined poly-stage treatment of patients with colon cancer with liver metastases. The cytotoxicity of various chemotherapeutic agents for colorectal carcinoma in the lines of HT 29 and NMG 64/84 cells was studied by analysis of human colony-forming tumor (HTCA). In vitro studies on the suspension of tumor cells from remote liver metastases were carried out to determine the most effective chemotherapeutic agents for intra-arterial hepatic infusion (HAI). Individual choice of the scheme of systemic chemotherapy depends on the level of thymidylate synthetase (TS) in the tumor tissue. Long-term own clinical experience and analysis of world literature allow authors to state that stage resection of the liver (STR) in combination with regional (HAI) and systemic chemotherapy is the method of choice in the treatment of patients with colorectal cancer with unresectable liver metastases. In comparison with other treatment methods (ALPPS and TSH), STR has the least negative consequences and is beneficial from the tumor-biological point of view.

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The authors declare that there are no conflicts of interest present.