Can advanced colorectal cancer be cured?

In recent years, with the improvement of living standards, the irrational combination of meat and vegetables, longer life expectancy, environmental pollution and other factors have caused the incidence of colorectal cancer to increase year by year. At the same time, due to the lack of colorectal cancer screening programs in our country, and the fact that many people do not know much about colorectal cancer, they do not go to see a doctor after symptoms such as blood in the stool appear, resulting in the majority of colorectal cancer patients in our country being diagnosed in the late stage, which has a great impact on the treatment of colorectal cancer, especially for some patients with distant metastasis.

Colorectal cancer liver metastasis still has a chance of cure

Clinical data show that more than 50% of colorectal cancers will have liver metastases, of which about 25% of new colorectal cancers are accompanied by synchronous liver metastases. Only 20% of patients with liver metastases at the first diagnosis have the possibility of radical surgery, and the vast majority of patients cannot obtain radical resection of liver metastases. Professor Xu Ruihua, deputy director of the Affiliated Cancer Hospital of Sun Yat-sen University, pointed out that the median survival time of patients with resectable colorectal cancer liver metastases is about 35 months, and the 5-year survival rate is about 30% to 50%. The prognosis of patients whose liver metastases cannot be removed is much worse, so more active and scientific treatment measures should be taken to try to transform the original unresectable liver metastases into resectable ones, and to maximize the treatment effect.

Chinese medical experts pointed out that the median survival of patients with colorectal liver metastasis who do not receive treatment is only 6 to 12 months, and the median survival of patients with liver metastasis who receive chemotherapy alone is 12 to 24 months, and very few can survive for more than 5 years. The 5-year survival rate of patients with liver metastasis who can receive radical surgery can reach 35 to 58 percent.

Therefore, patients with unresectable liver metastases should receive neoadjuvant therapy, that is, drug therapy or radiotherapy before surgery to shrink the tumor tissue to a range that can be operated on, and then perform radical resection surgery. Chemotherapy combined with molecular targeted drugs represented by Erbitux can significantly improve chemotherapy response rate and liver resection rate, reduce tumor volume, improve patient quality of life, and prolong survival time. Two recent studies have shown that the addition of targeted therapy has converted approximately 34% and 58% of patients into resectable patients.

This means that after the liver metastases of these advanced patients are converted to resectable ones, their median survival is extended by 2 to 3 times, and they will regain hope of life. Experts also remind that when recurrent or metastatic colorectal cancer is confirmed, the K-ras gene status should be tested; for KRAS wild-type patients, the treatment of Erbitux combined with standard chemotherapy can achieve satisfactory prognosis for 60% of patients.