Cui Hong-Ming, Shu Xin-Peng, Wei Zheng-Qiang, Wu Xing-Ye
Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Front Oncol. 2024 Jun 27;14:1372812. doi: 10.3389/fonc.2024.1372812. eCollection 2024.
Colorectal cancer (CRC) is one of the most common cancers worldwide. In the treatment of patients with CRC, oxaliplatin plays a pivotal role, with moderate side effects. Neurotoxicity, myelosuppression, ototoxicity, delayed hypersensitivity reactions, and rhabdomyolysis induced by oxaliplatin have been reported individually. However, the occurrence of oxaliplatin-induced ascites has not been reported previously. The objectives of this case report were to elaborate on the rare occurrence of ascites in a patient with CRC after oxaliplatin therapy and to explore its characteristics and causes.
We report on a case of upper rectal cancer seen in a 65-year-old man who underwent robotic-assisted laparoscopic anterior rectal resection. The patient developed ascites during postoperative adjuvant therapy with oxaliplatin and capecitabine. We ruled out tumor recurrence by laparoscopy, intraoperative biopsy, and biochemistry of the ascites. The patient did not experience a recurrence of ascites after discontinuation of chemotherapy.
This case suggests that chemotherapy with oxaliplatin might cause ascites. The mechanism of the oxaliplatin-induced liver injury was further discussed, which might have been the cause of ascite formation. When patients with CRC who underwent chemotherapy with oxaliplatin develop ascites, surgeons should actively determine whether this is a side effect of chemotherapy or is due to tumor recurrence in order to avoid unnecessary surgery.
结直肠癌（CRC）是全球最常见的癌症之一。在CRC患者的治疗中，奥沙利铂起着关键作用，且副作用中等。奥沙利铂引起的神经毒性、骨髓抑制、耳毒性、迟发型超敏反应和横纹肌溶解已分别有报道。然而，此前尚未有奥沙利铂诱导腹水发生的报道。本病例报告的目的是详细阐述一名CRC患者在接受奥沙利铂治疗后罕见的腹水发生情况，并探讨其特征和原因。
我们报告一例65岁男性的上段直肠癌病例，该患者接受了机器人辅助腹腔镜直肠前切除术。患者在术后接受奥沙利铂和卡培他滨辅助治疗期间出现腹水。我们通过腹腔镜检查、术中活检和腹水生化检查排除了肿瘤复发。化疗停药后患者腹水未再复发。
本病例提示奥沙利铂化疗可能导致腹水。进一步讨论了奥沙利铂诱导肝损伤的机制，这可能是腹水形成的原因。当接受奥沙利铂化疗的CRC患者出现腹水时，外科医生应积极确定这是化疗的副作用还是肿瘤复发所致，以避免不必要的手术。
