Tate Tomohiro, Fukui Yudai, Tomizawa Kenji, Hanaoka Yutaka, Toda Shigeo, Matoba Shuichiro, Kuroyanagi Hiroya
Dept. of Gastroenterological Surgery, Toranomon Hospital.
Gan To Kagaku Ryoho. 2017 Oct;44(10):871-873.
We present a case of bilateral lymph node metastases of rectal cancer treated with chemotherapy and surgery. The patient was a 65-year-old man with upper rectal cancer. Laparoscopic low anterior resection(LAR)was performed. Pathological findings were tub2>por>muc, pT3, ly2, v3, pN2, pM0. Six months after surgery, the CEA level was elevated. CT and PET-CT confirmed bilateral metastasis to the lymph nodes. Five courses of FOLFOX4 plus bevacizumab were administered, and then, we performed laparoscopic bilateral lymph node dissection. Pathological assessments confirmed scarring and fibrosis, that is, a pathological complete response(pCR)was achieved. Two years and 6 months after surgery, no recurrence was detected. After chemotherapy or chemoradiotherapy, we should perform surgery to prevent local recurrence, especially to the lateral lymph nodes.
我们报告一例经化疗和手术治疗的直肠癌双侧淋巴结转移病例。患者为一名65岁男性，患有上段直肠癌。行腹腔镜低位前切除术（LAR）。病理结果为tub2>por>muc，pT3，ly2，v3，pN2，pM0。术后6个月，癌胚抗原（CEA）水平升高。CT和PET-CT证实双侧淋巴结转移。给予5个疗程的FOLFOX4加贝伐单抗治疗，然后，我们进行了腹腔镜双侧淋巴结清扫术。病理评估证实有瘢痕形成和纤维化，即达到了病理完全缓解（pCR）。术后2年6个月，未检测到复发。化疗或放化疗后，我们应进行手术以预防局部复发，尤其是外侧淋巴结复发。
