Department of Gastroenterological Surgery, St. Marianna University Yokohama-City-West Hospital, 1197-1 Yasashi-cho, Asahi-ku, Yokohama, 241-0811, Japan;
J Gastrointest Oncol. 2013 Jun;4(2):E5-E10. doi: 10.3978/j.issn.2078-6891.2012.060.
We herein report the case of a patient who showed a pathological complete response after undergoing chemotherapy with capecitabine, oxaliplatin and bevacizumab. The patient presented with synchronous solitary liver metastasis from sigmoid colon cancer. The maximum diameter of the liver deposit was 5.7 cm and the grade of the liver metastasis was H2 according to the Japanese classification. Deferred hepatectomy after sigmoidectomy was performed, followed by the administration of neoadjuvant chemotherapy. After undergoing sigmoidectomy, the patient received 1,000 mg/m(2) of capecitabine and 130 mg/m(2) of oxaliplatin without bevacizumab as the first cycle of chemotherapy followed by eight cycles of chemotherapy with bevacizumab (7.5 mg/kg) every three weeks. The liver deposit was reduced to 2.2 cm in diameter and the patient showed a partial response to chemotherapy. The patient then underwent metastasectomy of segment 8 of the liver instead of the central hepatectomy that was possibly needed before chemotherapy. Histopathologically, the tumor consisted of fibrous tissue, and no cancer cells were detected in the resected specimen. A pathological complete response in a patient with H2 liver metastasis is considered rare and suggests that capecitabine, oxaliplatin and bevacizumab are efficacious as neoadjuvant chemotherapy.
我们在此报告了一例患者，该患者在接受卡培他滨、奥沙利铂和贝伐珠单抗化疗后表现出病理性完全缓解。该患者为乙状结肠癌的同步性孤立性肝转移。肝沉积的最大直径为 5.7cm，根据日本分类，肝转移的分级为 H2。乙状结肠切除术后行延期肝切除术，然后进行新辅助化疗。乙状结肠切除术后，患者接受了 1000mg/m(2)的卡培他滨和 130mg/m(2)的奥沙利铂，未使用贝伐珠单抗作为第一周期的化疗，随后进行了 8 个周期的化疗，每 3 周使用贝伐珠单抗（7.5mg/kg）。肝沉积直径缩小至 2.2cm，患者对化疗有部分缓解。然后，患者进行了肝 8 段的转移切除术，而不是化疗前可能需要的中央肝切除术。组织病理学上，肿瘤由纤维组织组成，切除标本中未检测到癌细胞。H2 肝转移患者的病理完全缓解被认为是罕见的，表明卡培他滨、奥沙利铂和贝伐珠单抗作为新辅助化疗是有效的。
