Urahama Ryuma, Toyozumi Takeshi, Kamata Toshiki, Isozaki Tetsuro, Sazuka Tetsutaro, Asai Yo, Kuboshima Mari, Tasaki Kentaro, Sugamoto Yuji, Fukunaga Toru, Kimura Masayuki, Matsubara Hisahiro
Dept. of Surgery, Numazu City Hospital.
Gan To Kagaku Ryoho. 2018 Dec;45(13):1875-1876.
A 67-year-old female was diagnosed with Stage Ⅳ rectal cancer with paraaortic lymph node metastasis. The patient underwent Hartmann's operation with D3 lymph node and paraaortic lymph node dissection. Postoperative chemotherapy with FOLFIRI was then administered for 1 year. However, liver metastasis developed, for which partial hepatectomy was performed. Postoperative chemotherapy with S-1(20 courses)was then administered. Three years and 11 months following the first operation, lymph node metastases developed and resection of lymph nodes(No. 12p, No. 16b1int)was performed. Postoperative chemotherapy with capecitabine(Cape)(8 courses)was then administered. Five years and 7 months following the first operation, Virchow lymph node metastasis developed. Despite chemotherapy with Cape and bevacizumab (Bmab), Virchow lymph node swelling recurred, and resection was performed. Nine years and 4 months following the first operation, lymph node metastases developed, and resection of lymph nodes(Virchow, No. 16b1int)was performed. Postoperative chemotherapy with S-1(8 courses)was then administered. At present, 11 years and 4 months after the first operation, the patient, whose chemotherapy has been discontinued, is alive without recurrence.
一名67岁女性被诊断为伴有主动脉旁淋巴结转移的Ⅳ期直肠癌。患者接受了Hartmann手术及D3淋巴结清扫和主动脉旁淋巴结清扫。随后给予FOLFIRI方案进行术后化疗1年。然而，出现了肝转移，为此进行了部分肝切除术。之后给予S-1方案进行术后化疗（20个疗程）。首次手术后三年零十一个月，出现淋巴结转移，进行了淋巴结切除（第12p组、第16b1组）。随后给予卡培他滨（希罗达）方案进行术后化疗（8个疗程）。首次手术后五年零七个月，出现魏尔啸淋巴结转移。尽管采用希罗达和贝伐单抗（安维汀）进行化疗，但魏尔啸淋巴结肿大仍复发，遂进行了切除。首次手术后九年零四个月，出现淋巴结转移，进行了淋巴结切除（魏尔啸组、第16b1组）。随后给予S-1方案进行术后化疗（8个疗程）。目前，首次手术后十一年零四个月，患者已停止化疗，仍存活且无复发。
