Joki Eita, Kato Hiroyuki, Tani Hiroki, Asano Yukio, Ito Masahiro, Arakawa Satoshi, Shimura Masahiro, Koike Daisuke, Ochi Takayuki, Kamio Kenshiro, Kawai Toki, Yasuoka Hironobu, Higashiguchi Takahiko, Kunimura Yoshiki, Horiguchi Kazuma, Nagata Hidetoshi, Kondo Yuka, Sato Harunobu, Kato Yutaro, Hanai Tsunekazu, Horiguchi Akihiko
Dept. of Surgery, Fujita Health University School of Medicine, Bantane Hospital.
Gan To Kagaku Ryoho. 2023 Aug;50(8):933-936.
We report a case of a patient with sigmoid colon cancer and multiple liver metastases who underwent hepatectomy after chemotherapy and pathological results showed complete remission. However, after chemotherapy was discontinued, the patient developed a local recurrence of the liver metastasis and underwent rehepatectomy. The patient came to our hospital with lower abdominal pain. Colonoscopy revealed a circumferential type Ⅱ, well-differentiated adenocarcinoma. Laparoscopic sigmoidectomy with lymph node dissection was performed. Postoperative CT scan showed multiple liver metastases at S5, S7, and S8. 11 cycles of bevacizumab plus modified FOLFOX(mFOLFOX)were subsequently performed. The liver metastases shrank at all sites, and the patient underwent right hepatectomy. The resected specimen was considered to be in complete remission, with no evidence of viable malignant cells. Postoperatively, bevacizumab plus mFOLFOX was resumed for 6 cycles and the patient remained in remission. However, 3 months after stopping chemotherapy and 1 year and 6 months after hepatectomy, a follow-up CT scan showed local recurrence of the liver edge, and a diagnosis of local recurrence of liver metastasis was made, and a partial hepatectomy was performed. The patient is recurrence-free and resuming modified FOLFOX 9 months after surgery.
我们报告了一例乙状结肠癌伴多发肝转移的患者,该患者在化疗后接受了肝切除术,病理结果显示完全缓解。然而,化疗停止后,患者出现肝转移局部复发并接受了再次肝切除术。患者因下腹部疼痛前来我院就诊。结肠镜检查显示为环状Ⅱ型高分化腺癌。行腹腔镜乙状结肠切除术并清扫淋巴结。术后CT扫描显示在S5、S7和S8有多发肝转移。随后进行了11个周期的贝伐单抗加改良FOLFOX(mFOLFOX)化疗。所有部位的肝转移灶均缩小,患者接受了右半肝切除术。切除标本被认为完全缓解,未发现存活的恶性细胞。术后,继续使用贝伐单抗加mFOLFOX进行6个周期化疗,患者仍处于缓解状态。然而,化疗停止3个月后,肝切除术后1年6个月,随访CT扫描显示肝边缘局部复发,诊断为肝转移局部复发,并进行了部分肝切除术。患者术后9个月无复发,正在恢复使用改良FOLFOX方案。