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[直肠癌多发肝转移患者多学科治疗长期生存病例报告]

[Report of a Case of Long-Term Survival with Mulitidisciplinary Therapy for a Patient with Multiple Liver Metastases from Rectal Cancer].

作者信息

Nagai Yasuo, Harano Masao, Ogawa Toshihiro, Komatsu Yasuhiro, Mimura Naoki, Satoh Daisuke, Sumitani Daisuke, Choda Yasuhiro, Nakano Kanyu, Matsukawa Hiroyoshi, Ojima Yasutomo, Idani Hitoshi, Okajima Masazumi, Shiozaki Shigehiro, Onoda Tadashi

机构信息

Dept. of Surgery, Hiroshima City Hiroshima Citizens Hospital.

出版信息

Gan To Kagaku Ryoho. 2016 Nov;43(12):2154-2156.

Abstract

Multidisciplinary therapy is necessary to prevent recurrence of advanced rectal cancer and advanced cancer with metastases. Here we report a case of long-term survival of a patient with advanced rectal cancer with multiple liver metastases. An 80's woman had previously undergone both Hartmann's operation and a partial hepatectomy for advanced rectal cancer with multiple liver metastases. A year after chemotherapy, a CT scan revealed multiple liver metastases. Thus, we performed partial liver resection. After another round of chemotherapy, a CT scan revealed lung metastases and local recurrence of the rectal cancer; therefore, we performed partial lung resection and a Miles operation. These procedures were conducted 4 years after her first operation. The following year, PET-CT revealed a mediastinum lymph node metastasis; consequently, we performed radiation therapy. New lung metastases and local recurrences of rectal cancer were identified after the radiation therapy; thus, we resumed the therapy, including a molecular targeting drug. Although the patient is in a tumor-bearing state, she is still alive 10 years after her first operation.

摘要

多学科治疗对于预防晚期直肠癌及伴有转移的晚期癌症复发是必要的。在此,我们报告一例伴有多处肝转移的晚期直肠癌患者长期生存的病例。一名80多岁的女性此前因伴有多处肝转移的晚期直肠癌接受了哈特曼手术和部分肝切除术。化疗一年后,CT扫描显示有多处肝转移。因此,我们进行了部分肝切除术。在另一轮化疗后,CT扫描显示有肺转移和直肠癌局部复发;于是,我们进行了部分肺切除术和腹会阴联合切除术。这些手术在她首次手术后4年进行。次年,PET-CT显示有纵隔淋巴结转移;因此,我们进行了放射治疗。放射治疗后发现有新的肺转移和直肠癌局部复发;于是,我们恢复了治疗,包括使用分子靶向药物。尽管该患者处于带瘤状态,但在首次手术后10年仍存活。

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