Ojima Toshihiko, Nezuka Hideaki, Earashi Mitsuharu, Saitou Tomohiro, Saitou Mitsukazu, Fujii Hisatake
Dept. of General Surgery, Yatsuo Medical Center.
Gan To Kagaku Ryoho. 2014 Nov;41(12):2425-7.
A 63-year-old man underwent laparoscopic-assisted distal gastrectomy (LADG) and laparoscopic assisted colectomy (LAC) simultaneously for double cancers of the gastric antrum and sigmoid colon in August 2012. Both cancers, considered to be at an early-Stage, were pathologically diagnosed as tub1, sm, and n0. The patient was observed but no adjuvant chemotherapy was administered. A follow-up computed tomography (CT) in December 2012 detected a 15 mm tumor mass in the lateral segment of the liver and another 5mm mass in the S4. Liver metastasis of the sigmoid colon cancer was suspected, and 6 courses of BEV+mFOLFOX6 were administered. The metastatic tumor in the lateral segment showed stable disease (SD) and the S4 tumor showed a complete response (CR). Thereafter, the lateral hepatic segment was partially resected in March 2013. Pathological examinations led to a diagnosis of stomach cancer liver metastasis, and the patient was given oral TS-1. During the first course of treatment, a CT showed new tumor masses in the lateral segment of the liver and S4. Treatment was changed to TS-1+CDDP in mid-May. However, after completion of the first course of treatment, the patient experienced exacerbation of the liver metastases, pulmonary metastasis, and inflammation of the intrahepatic bile ducts. The patient was hospitalized in mid-June to receive inpatient care, but died in early July.
一名63岁男性于2012年8月因胃窦和乙状结肠双癌同时接受了腹腔镜辅助远端胃切除术（LADG）和腹腔镜辅助结肠切除术（LAC）。这两种癌症均被认为处于早期阶段，病理诊断为tub1、sm和n0。对该患者进行了观察，但未给予辅助化疗。2012年12月的随访计算机断层扫描（CT）发现肝脏外侧段有一个15毫米的肿瘤肿块，S4段有另一个5毫米的肿块。怀疑为乙状结肠癌肝转移，给予6个疗程的BEV+mFOLFOX6治疗。外侧段的转移瘤显示病情稳定（SD），S4段的肿瘤显示完全缓解（CR）。此后，于2013年3月对肝脏外侧段进行了部分切除。病理检查诊断为胃癌肝转移，患者接受了口服替吉奥（TS-1）治疗。在第一个疗程的治疗期间，CT显示肝脏外侧段和S4段出现了新的肿瘤肿块。5月中旬治疗改为TS-1+顺铂（CDDP）。然而，在第一个疗程治疗完成后，患者出现肝转移加重、肺转移以及肝内胆管炎症。患者于6月中旬住院接受住院治疗，但于7月初死亡。
