Miyamae Yohei, Tomizawa Naoki, Hoshino Marie, Yamaguchi Arisa, Honda Ryouya, Takahashi Norifumi, Kurosaki Ryou, Shimizu Hisashi, Arakawa Kazuhisa, Ando Tatsumasa, Ide Munenori
Dept. of Surgery, Japanese Red Cross Maebashi Hospital.
Gan To Kagaku Ryoho. 2018 Dec;45(12):1755-1758.
A laparoscopy-assisted right hemicolectomy and D3 lymph node dissection were performed to treat a 60-year-old woman with ascending colon cancer. Microscopically, the resected specimen was diagnosed as adenocarcinoma(tub1>tub2, pSS, pN1, M0). Adjuvant chemotherapy using UFT/UZEL was administered for 6 months. Enlarged para-aortic lymph nodes were identified by follow-up CT 2 years post operation, and a para-aortic lymph node dissection was performed. Microscopic examination revealed that the #216 b1 int lymph node contained poorly differentiated metastatic adenocarcinoma. After 36 courses of FOLFOX as adjuvant chemotherapy, the chemotherapy was discontinued because of an adverse event. She has remained well without recurrence for 5 years after the second surgery. There have been reports of survival improvements by surgical resections in patients with solitary para-aorta lymph node metastases of colorectal cancer. These observations suggest that the surgical therapy may have contributed to the improved prognosis in the present case.
对一名60岁升结肠癌女性患者实施了腹腔镜辅助右半结肠切除术及D3淋巴结清扫术。显微镜检查显示，切除标本诊断为腺癌（tub1>tub2，pSS，pN1，M0）。采用优福定/尿嘧啶替加氟进行了6个月的辅助化疗。术后2年的随访CT检查发现腹主动脉旁淋巴结肿大，遂进行了腹主动脉旁淋巴结清扫术。显微镜检查显示，#216 b1组间淋巴结含有低分化转移性腺癌。在进行36个疗程的FOLFOX辅助化疗后，因不良事件停止化疗。二次手术后她已无复发存活5年。有报道称，对结直肠癌孤立性腹主动脉旁淋巴结转移患者进行手术切除可提高生存率。这些观察结果表明，手术治疗可能是本例预后改善的原因。
