Yoshidome Hiroyuki, Kimura Fumio, Shimizu Hiroaki, Ohtsuka Masayuki, Kato Atsushi, Yoshitomi Hideyuki, Furukawa Katsunori, Takeuchi Dan, Takayashiki Tsukasa, Suda Kosuke, Kuboki Satoshi, Miyazaki Masaru
Dept. of General Surgery, Chiba University Graduate School of Medicine, Japan.
Gan To Kagaku Ryoho. 2011 Nov;38(11):1853-6.
A 63-year-old woman with a synchronous huge colorectal liver metastasis was referred to our institution.The lesion was technically diagnosed unresectable because the estimated future remnant liver volume was insufficient due to the invasion of the three hepatic veins and hepatic hilum.She underwent 7 courses of mFOLFOX6 and 14 administrations of cetuximab as conversion chemotherapy.Periodic abdominal CT scans revealed the tumor becoming PR, and she was free of cancer invasion to the left hepatic vein.After the remainder of chemotherapy lasting 4 weeks, right trisectionectomy and combined partial resection of the inferior vena cava and primary closure was performed.The postoperative course was uneventful and the patient was discharged at 20 days after the operation.She underwent chemotherapy postoperatively, and then underwent laparoscopic sigmoidectomy.A conversion chemotherapy using cetuximab may contribute to ward rapidly reducing tumor size and improving the resectability of initially unresectable huge colorectal liver metastases, thus leading to prolonged survival.
一名63岁患有同步性巨大结直肠癌肝转移的女性被转诊至我院。由于三条肝静脉和肝门受侵，预计未来残余肝体积不足，该病变经技术诊断为不可切除。她接受了7个疗程的mFOLFOX6方案及14次西妥昔单抗给药作为转化化疗。定期腹部CT扫描显示肿瘤达到部分缓解（PR），且癌灶未侵犯左肝静脉。在持续4周的剩余化疗后，进行了右半肝切除术及下腔静脉联合部分切除并一期缝合。术后过程顺利，患者于术后20天出院。她术后接受了化疗，随后接受了腹腔镜乙状结肠切除术。使用西妥昔单抗的转化化疗可能有助于迅速缩小肿瘤大小并提高最初不可切除的巨大结直肠癌肝转移灶的可切除性，从而延长生存期。
