Kurata Yoshihiro, Imai Yasuo, Hirata Atsushi, Ichinose Masanori
Department of Digestive Surgery, International University of Health and Welfare, Shioya Hospital, Yaita, Tochigi 329-2145, Japan.
Department of Frontier Surgery, Graduate School of Medicine, Chiba University, Chiba, Chiba 260-8677, Japan.
Oncol Lett. 2024 Jan 23;27(3):117. doi: 10.3892/ol.2024.14250. eCollection 2024 Mar.
The treatment strategies for colorectal cancer (CRC) with distant metastasis or metastatic recurrence after resection of the primary tumor are controversial. In the present study, four cases of patients with advanced CRC with distant metastasis who achieved disease-free survival (DFS) for >5 years and were deemed potentially cured were reported. Case 1 was that of a 53-year-old male patient with rectal cancer and liver metastases (pT3N2bM1, pStage IV), and case 2 was that of a 58-year-old female patient with descending colon cancer (pT3N1M1, pStage IV) who had lung metastases at surgery and postoperatively. Both patients achieved DFS for >5 years after simultaneous or staged partial hepatectomy or pneumonectomy followed by chemotherapy. Case 3 was that of a 75-year-old male patient with transverse colon cancer (pT3N1M0, pStage IIIB) and case 4 was that of a 73-year-old male patient with sigmoid colon cancer (pT3N0M0, pStage IIA). These cases developed liver metastases after resection of the primary tumour and were subsequently treated with chemotherapy before or after partial hepatectomy. DFS for >5 years was achieved. All four patients were considered cured. The data revealed that even patients with CRC and distant metastases can potentially be cured following multidisciplinary treatment. In the present case report, the factors that enabled these patients to be considered cured were discussed and the aim was to improve the treatment strategy to cure CRC with distant metastasis or recurrence.
原发性肿瘤切除术后出现远处转移或转移复发的结直肠癌(CRC)的治疗策略存在争议。在本研究中,报告了4例晚期CRC伴远处转移且无病生存期(DFS)>5年并被认为可能治愈的患者。病例1是一名53岁的男性直肠癌伴肝转移患者(pT3N2bM1,pIV期),病例2是一名58岁的女性降结肠癌患者(pT3N1M1,pIV期),手术时及术后有肺转移。两名患者在同期或分期进行部分肝切除术或肺切除术后接受化疗,均实现了>5年的DFS。病例3是一名75岁的男性横结肠癌患者(pT3N1M0,pIIIB期),病例4是一名73岁的男性乙状结肠癌患者(pT3N0M0,pIIA期)。这些病例在原发性肿瘤切除后发生肝转移,随后在部分肝切除术前或术后接受化疗,实现了>5年的DFS。所有4例患者均被认为已治愈。数据显示,即使是CRC伴远处转移的患者,经多学科治疗后也有可能治愈。在本病例报告中,讨论了使这些患者被认为治愈的因素,目的是改进治疗策略以治愈伴远处转移或复发的CRC。