Watanabe Takaoki, Kobayashi Takashi, Wakai Atsuhiro, Yagi Ryoma, Tanaka Kana, Miura Kohei, Tajima Yosuke, Nagahashi Masayuki, Shimada Yoshifumi, Sakata Jun, Kameyama Hitoshi, Kobayashi Takashi, Wakai Toshifumi
Dept. of Surgery, Niigata Rinko Hospital.
Gan To Kagaku Ryoho. 2016 Nov;43(12):2139-2141.
We report here a case of long-term survival with repeated peritoneal recurrences after resection of perforated sigmoid colon cancer. A 65-year-old man presented with diarrhea and abdominal pain. Computed tomography(CT)revealed diffuse peritonitis caused by perforated sigmoid colon cancer. We performed sigmoidectomy with D2 lymphadenectomy and descending colostomy. Postoperatively, S-1 was administered for 12 months as adjuvant chemotherapy. CT showed peritoneal nodules 56 months after the surgery. After 10 courses of mFOLFOX6 plus bevacizumab, the tumors decreased in size (reduction rate of 34.4%; a partial response). Subsequently, 3 peritoneal nodules were resected with curative intent. Another peritoneal nodule was detected 57 months after the second surgery. After 3 courses of XELOX plus bevacizumab, the nodule decreased in size(reduction rate of 69.0%; a partial response). The nodule was resected with a curative intent. At the last follow-up 135 months after the first surgery, the patient remains alive with no evidence of disease.
我们在此报告一例乙状结肠癌穿孔切除术后反复出现腹膜复发但长期存活的病例。一名65岁男性因腹泻和腹痛就诊。计算机断层扫描（CT）显示乙状结肠癌穿孔导致弥漫性腹膜炎。我们进行了乙状结肠切除术加D2淋巴结清扫术及降结肠造口术。术后，给予S-1辅助化疗12个月。术后56个月CT显示腹膜结节。在接受10个疗程的mFOLFOX6加贝伐单抗治疗后，肿瘤缩小（缩小率为34.4%；部分缓解）。随后，以根治性意图切除了3个腹膜结节。第二次手术后57个月又发现一个腹膜结节。在接受3个疗程的XELOX加贝伐单抗治疗后，该结节缩小（缩小率为69.0%；部分缓解）。该结节以根治性意图切除。在第一次手术后135个月的最后一次随访中，患者仍存活，无疾病证据。
