Takahashi Toru, Itoh Yutaka
Dept. of Gastroenterological and Breast Surgery, National Disaster Medical Center.
Gan To Kagaku Ryoho. 2009 Dec;36(13):2669-72.
The patient was a 42-year-old female who had advanced rectal cancer(Ra, type 2)with liver metastasis. The preoperative diagnosis was T2N1H2, but the liver tumor was unresectable for hepatic vein invasion in September, 2004. She underwent low anterior resection for primary rectal cancer at first after she was given S-1 80 mg/day(14 days)for a histological effect judgment. The pathological diagnosis was moderately-differentiated adenocarcinoma, ss, n1, and the histological effect was Grade 1a. Because CT showed reduction of liver metastasis after the operation, she was treated with 2 courses of chemotherapy using S-1. Radiographic examination showed reduction of liver metastasis(36%)and improvement of hepatic vein invasion. In January, 2005, she underwent hepatectomy and the pathological diagnosis was moderately-differentiated adenocarcinoma, metastasis and the histological effect was Grade 1a. There has not been any recurrence for 48 months after hepatectomy. We experienced this case in which preoperative S-1 proved effective for liver metastasis from rectal cancer.
该患者为一名42岁女性,患有晚期直肠癌(Ra,2型)并伴有肝转移。术前诊断为T2N1H2,但由于肝静脉受侵,2004年9月肝脏肿瘤无法切除。在给予S-1 80毫克/天(共14天)以判断组织学疗效后,她首先接受了原发性直肠癌的低位前切除术。病理诊断为中分化腺癌,ss,n1,组织学疗效为1a级。由于术后CT显示肝转移灶缩小,她接受了2个疗程的S-1化疗。影像学检查显示肝转移灶缩小(36%),肝静脉受侵情况改善。2005年1月,她接受了肝切除术,病理诊断为中分化腺癌,转移,组织学疗效为1a级。肝切除术后48个月未出现任何复发。我们遇到了这样一个病例,术前使用S-1对直肠癌肝转移有效。