Ouyang Ye, Zhu Yilin, Chen Haoyi, Li Guoquan, Hu Xiongwei, Luo Hongyu, Li Zhou, Han Shuai
The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China.
Department of General Surgery, Guangdong Province Huizhou Sixth Hospital, Huizhou, China.
Front Oncol. 2023 May 15;13:1169616. doi: 10.3389/fonc.2023.1169616. eCollection 2023.
Rectal cancer has a high risk of recurrence and metastasis, with median survival ranging from 24 months to 36 months. K-RAS mutation is a predictor of poor prognosis in rectal cancer. Advanced rectal cancer can be stopped in its tracks by pelvic exenteration.
A 51-year-old woman was diagnosed with advanced rectal cancer (pT4bN2aM1b, stage IV) with the KRAS G12D mutation due to a change in bowel habits. The patient had experienced repeated recurrences of rectal cancer after initial radical resection, and the tumor had invaded the ovaries, sacrum, bladder, vagina and anus. Since the onset of the disease, the patient had undergone a total of seven surgeries and long-term FOLFIRI- or XELOX-based chemotherapy regimens, with the targeted agents bevacizumab and regorafenib. Fortunately, the patient was able to achieve intraoperative R0 resection in almost all surgical procedures and achieve tumor-free survival after pelvic exenteration. The patient has been alive for 86 months since her diagnosis.
Patients with advanced rectal cancer can achieve long-term survival through active multidisciplinary management and R0 surgery.
直肠癌具有较高的复发和转移风险，中位生存期为24个月至36个月。K-RAS突变是直肠癌预后不良的一个预测指标。晚期直肠癌可通过盆腔脏器清除术得到控制。
一名51岁女性因排便习惯改变被诊断为晚期直肠癌（pT4bN2aM1b，IV期），伴有KRAS G12D突变。该患者在初次根治性切除术后经历了直肠癌的多次复发，肿瘤已侵犯卵巢、骶骨、膀胱、阴道和肛门。自发病以来，患者共接受了7次手术以及基于FOLFIRI或XELOX方案的长期化疗，并使用了靶向药物贝伐单抗和瑞戈非尼。幸运的是，患者在几乎所有手术中均能实现术中R0切除，并在盆腔脏器清除术后实现无瘤生存。自确诊以来，该患者已存活86个月。
晚期直肠癌患者通过积极的多学科管理和R0手术可实现长期生存。
