Okabe Toshio, Nakamura Masaya, Hoshino Kazuo, Sunose Yutaka, Takeyoshi Izumi
Dept. of Surgery, Imai Hospital.
Gan To Kagaku Ryoho. 2014 May;41(5):657-60.
A 58-year-old man underwent low anterior resection for type 2 rectal cancer with liver metastasis. An abdominal computed tomography (CT) scan showed multiple hepatic tumors (in S2, S3, S4, and S6) and a filling defect in the left portal vein. Pathological examination revealed a moderately differentiated adenocarcinoma, pSS, pN0, ly0, v3, with a tumor thrombus in the portal vein. After surgery, the patient was treated with combined chemotherapy of bevacizumab/Leucovorin and fluorouracil with oxaliplatin (FOLFOX4). After 11 courses of chemotherapy, tumor marker levels normalized, and the sizes of the liver metastases and thrombus in the left portal vein remarkably decreased. Resection of the left hepatic lobe and a partial resection of S6 were performed. Pathological examination revealed no residual cancer cells and indicated that the histological classification due to the chemotherapy regimen was Grade 3. The patient was alive for 5 years after the initial surgery, without recurrence.
一名58岁男性因2型直肠癌伴肝转移接受了低位前切除术。腹部计算机断层扫描（CT）显示多个肝肿瘤（位于S2、S3、S4和S6）以及左门静脉充盈缺损。病理检查显示为中度分化腺癌，pSS，pN0，ly0，v3，门静脉有肿瘤血栓形成。术后，患者接受了贝伐单抗/亚叶酸钙和氟尿嘧啶联合奥沙利铂（FOLFOX4）的化疗。经过11个疗程的化疗后，肿瘤标志物水平恢复正常，肝转移灶及左门静脉血栓大小明显减小。进行了左肝叶切除及S6部分切除。病理检查未发现残留癌细胞，且表明化疗方案导致的组织学分类为3级。患者在初次手术后存活了5年，无复发。
