Kobayashi Hirotoshi, Uetake Hiroyuki, Higuchi Tetsuro, Enomoto Masayuki, Iida Satoru, Ishikawa Toshiaki, Ishiguro Megumi, Kato Shunsuke, Matsuyama Takatoshi, Ono Hiroaki, Yamauchi Shinichi, Masuda Daiki, Sugihara Kenichi
Center for Minimally Invasive Surgery, Tokyo Medical and Dental University.
Gan To Kagaku Ryoho. 2011 Nov;38(12):2301-3.
We describe the case of a 74-year-old man with liver resection for originally unresectable liver metastasis from colorectal cancer after multiagent chemotherapy. Eleven bilobar liver metastases appeared four months after curative resection for double cancer of sigmoid colon and upper rectum. After 6 courses of multiagent chemotherapy (mFOLFOX 6 with bevacizumab), the number of liver metastasis decreased from 11 to 5. The patient underwent curative resection for liver metastasis. A new lesion of 7 mm in the segment 6 appeared 8 months after an initial liver resection. After 3 months' observation, two more liver metastases appeared. All liver metastases were resected. Solitary lung metastasis appeared 10 months after the second liver resection. The lung metastasis was also resected. The patient was alive with no evidence of disease in 33 months after the initial liver resection. We experienced the case with repeated liver resections after multiagent chemotherapy for originally unresectable bilobar liver metastasis. The therapeutic strategy which combines surgical resection with cytotoxic chemotherapy will be important more than ever.
我们描述了一例74岁男性患者的病例,该患者因最初无法切除的结直肠癌肝转移在接受多药化疗后进行了肝切除术。在乙状结肠和上段直肠癌根治性切除术后四个月出现了11个双侧肝转移灶。经过6个疗程的多药化疗(mFOLFOX 6联合贝伐单抗),肝转移灶数量从11个减少到5个。患者接受了肝转移灶的根治性切除术。在初次肝切除术后8个月,6段出现了一个7毫米的新病灶。经过3个月的观察,又出现了两个肝转移灶。所有肝转移灶均被切除。在第二次肝切除术后10个月出现了孤立性肺转移。肺转移灶也被切除。在初次肝切除术后33个月,患者存活且无疾病证据。我们遇到了一例最初无法切除的双侧肝转移在多药化疗后反复进行肝切除的病例。将手术切除与细胞毒性化疗相结合的治疗策略将比以往任何时候都更加重要。