Hata Taishi, Shinke Go, Katsuyama Shinsuke, Ikeshima Ryo, Kawai Kenji, Hiraki Masayuki, Katsura Yoshiteru, Ohmura Yoshiaki, Sugimura Keijiro, Masuzawa Toru, Takeda Yutaka, Kawabata Gaku, Murata Kohei
Dept. of Surgery, Kansai Rosai Hospital.
Gan To Kagaku Ryoho. 2022 Dec;49(13):1613-1615.
The patient was male, 50s. He visited his local doctor with complaints of hematochezia and hematuria. He underwent colonoscopy, which revealed a circumferential lesion in the sigmoid colon, and he was referred to our department for further examination and treatment. A urinalysis at the time of admission revealed leukocytes(3+)and bacteria(2+), suggesting that the sigmoid colon cancer was invading the bladder. The urologist performed cystoscopy, which showed internal invasion of the bladder, and at this point, including the CT findings, it was needed that a combined bladder resection was necessary. We decided to undergo neoadjuvant chemotherapy(NAC)with the possibility of bladder preservation. FOLFOXIRI plus bevacizumab was selected as the regimen, and a total of 6 courses were performed. After NAC, the effect was judged PR. The patient underwent laparoscopy-assisted resection of the sigmoid colon and partial resection of the bladder wall. The pathological diagnosis was ypStage Ⅱc. Postoperatively, the patient received 6 courses of FOLFOX as adjuvant chemotherapy. Currently, about 8 months after surgery, no recurrence has been observed.
患者为男性，50多岁。他因便血和血尿症状前往当地医生处就诊。他接受了结肠镜检查，结果显示乙状结肠有一个环形病变，随后被转诊至我科进行进一步检查和治疗。入院时的尿液分析显示白细胞（3+）和细菌（2+），提示乙状结肠癌侵犯膀胱。泌尿科医生进行了膀胱镜检查，结果显示膀胱内部有侵犯，结合CT检查结果，此时需要进行膀胱联合切除术。我们决定进行新辅助化疗（NAC），以期保留膀胱。选择FOLFOXIRI联合贝伐单抗作为化疗方案，共进行了6个疗程。新辅助化疗后，疗效判定为部分缓解（PR）。患者接受了腹腔镜辅助乙状结肠切除术和膀胱壁部分切除术。病理诊断为ypⅡc期。术后，患者接受了6个疗程的FOLFOX辅助化疗。目前，术后约8个月，未观察到复发情况。
