Kuhara Kotaro, Shiozawa Shunichi, Yokomizo Hajime, Usui Takebumi, Shimojima Yukio, Nakayasu Yasuyo, Kono Teppei, Tsuchiya Akira, Asaka Shinichi, Yoshimatsu Kazuhiko, Shimakawa Takeshi, Katsube Takao, Ohigashi Seiji
Dept. of Surgery, Tokyo Women's Medical University, Medical Center East.
Gan To Kagaku Ryoho. 2020 Dec;47(13):1833-1835.
We hereby report a case of advanced and recurrent colon cancer with long-term survival after 7 repeated surgical resections. A 73-year-old woman initially underwent right hemicolectomy and partial hepatectomy for an ascending colon cancer with synchronous liver metastasis. Pathological diagnosis of the tumors were moderately differentiated adenocarcinoma and metastasis to the liver compatibly. Final clinical stage was diagnosed as fT3N2M1(H1), fStage Ⅳ. But she was interrupted oxaliplatin-based adjuvant chemotherapy after 6 courses of CAPOX because of adverse drug reaction. One year after first operation, partial resection of right lung was performed for lung metastasis. Two years after first operation, 2nd resection of liver was performed for 2 liver metastatic lesions. Three years after first operation, 3rd partial liver resection, 2nd and 3rd partial lung resections were performed for metachronous metastases during 1 year. After 3 years recurrence free period, she complained of an induration of right neck and diagnosed as neck and supra clavicular lymph nodes metastases. Lymph nodes resection was performed. After the last operation, she has no sign of cancer recurrence for 1 year and 7 months, eventually she has been alive for 7 years and 7 months after the initial operation.
我们在此报告一例晚期复发性结肠癌患者，经7次重复手术切除后长期存活。一名73岁女性最初因升结肠癌伴同时性肝转移接受了右半结肠切除术和部分肝切除术。肿瘤的病理诊断为中分化腺癌，并符合肝转移。最终临床分期诊断为fT3N2M1(H1)，f期Ⅳ。但由于药物不良反应，她在接受6个疗程的CAPOX辅助化疗后中断了基于奥沙利铂的化疗。首次手术后1年，因肺转移进行了右肺部分切除术。首次手术后2年，因2个肝转移灶进行了第2次肝脏切除术。首次手术后3年，在1年内因异时性转移进行了第3次部分肝切除术、第2次和第3次部分肺切除术。在3年无复发期后，她主诉右颈部硬结，被诊断为颈部和锁骨上淋巴结转移。进行了淋巴结切除术。最后一次手术后，她已无癌症复发迹象达1年7个月，最终在初次手术后存活了7年7个月。
