Hakoda Keishi, Yoshimitsu Masanori, Emi Manabu, Omori Ichiro, Kohashi Toshihiko, Kaneko Mayumi, Ohdan Hideki, Hirabayashi Naoki
Department of Surgery, Hiroshima City Asa Citizens Hospital, Hiroshima, Japan.
Division of Pathology, Hiroshima City Asa Citizens Hospital, Hiroshima, Japan.
Oxf Med Case Reports. 2017 May 30;2017(5):omx016. doi: 10.1093/omcr/omx016. eCollection 2017 May.
We report a case of a pathological complete response (pCR) with chemotherapy for multiple huge liver metastases from colon cancer. A 59-year-old woman presented with anorexia and weight loss. Laboratory tests revealed elevated liver enzyme levels and tumor markers. A computed tomography/positron emission tomography-computed tomography scan revealed a transverse colon tumor and unresectable liver masses measuring 9.0 cm in maximum diameter in segments 7 and 8, with another mass in segment 6. She underwent laparoscopic colectomy and was administered FOLFOX + BV. After 11-cycles of chemotherapy, the liver masses became resectable with a partial response, so hepatectomy was performed. On the final histopathological analysis, all lesions were fibrotic without any viable cancer cells. The patient is alive without recurrence 2 years after resection. We believe this is the largest tumor of unresectable colorectal liver metastasis (CRLM) that has ever resulted in pCR with chemotherapy. FOLFOX + Bev was thus found to be an effective treatment for unresectable CRLM.
我们报告了一例结肠癌多发巨大肝转移经化疗后达到病理完全缓解（pCR）的病例。一名59岁女性出现厌食和体重减轻。实验室检查显示肝酶水平和肿瘤标志物升高。计算机断层扫描/正电子发射断层扫描-计算机断层扫描显示横结肠肿瘤以及在第7和第8段最大直径达9.0 cm的不可切除肝脏肿块，第6段还有一个肿块。她接受了腹腔镜结肠切除术，并给予FOLFOX + 贝伐单抗治疗。经过11个周期的化疗后，肝脏肿块变为可切除且部分缓解，于是进行了肝切除术。最终的组织病理学分析显示，所有病变均为纤维化，无任何存活癌细胞。患者在切除术后2年仍存活且无复发。我们认为这是有史以来经化疗实现pCR的最大的不可切除结直肠癌肝转移（CRLM）肿瘤。因此，FOLFOX + 贝伐单抗被发现是治疗不可切除CRLM的有效方法。
