内容紹介
Long-Term Survival of a Patient with Sigmoid Colon Cancer Showing Multiple Liver Metastases Treated by Performing Partial Hepatectomy, Five Years after Achieving a Complete Response via Hepatic Arterial Infusion Chemotherapy
Summary
Although systemic multidrug chemotherapy is the first-line therapy for unresectable colorectal cancer, hepatic arterial infusion chemotherapy(HAI)may be a potential alternative treatment for patients with unresectable colorectal liver metastasis. A 65-year-old man underwent sigmoidectomy for sigmoid colon cancer with bilobar, multiple liver metastases. Postoperatively, an HAI regimen of 5-fluorouracil(5-FU, 1,000 mg/m2/5 h/every week)was administered for 26 weeks; the total dose of 5-FU administered was 52 g. Complete response(CR)was achieved, according to an imaging diagnosis technique. Thereafter, the patient was followed-up in an outpatient setting, without any further anti-cancer treatment. A solitary liver metastasis was identified by using magnetic resonance imaging(MRI), 6 years 6 months after achieving CR. The patient underwent partial liver resection for the recurrent liver metastasis. Histological diagnosis revealed an adenocarcinoma, consistent with the findings for metastatic sigmoid colon cancer. The patient's postoperative recovery was uneventful, and he remains alive 5 years after liver resection, without any evidence of tumor recurrence. Further long-term follow-up might be advisable considering the slow-growing nature of this tumor.
要旨
症例は65歳,男性。2000年11月,両葉多発肝転移を伴うS状結腸癌でS状結腸切除術を施行。術後1か月目に肝動注化学療法(5-FU 1,000 mg/m2/5時間/週)を開始。12コース終了時点では肝転移の遺残があり,計26コース終了後に完全寛解(CR)となった。以後,無化療で経過観察。2008年1月のMRIでS4に肝転移巣を同定。経上腸間膜動脈性門脈造影下CT(CTAP)で単発病変と診断し,3月に肝部分切除を施行した。病理組織学的にも大腸癌肝転移に矛盾しない像であった。肝切除後,無化療で5年を経過したが,再発兆候は認めていない。肝動注終了後6年6か月で再燃したことからslow-growingな腫瘍であると思われ,今後も長期的な経過観察が必要である。
目次
Summary
Although systemic multidrug chemotherapy is the first-line therapy for unresectable colorectal cancer, hepatic arterial infusion chemotherapy(HAI)may be a potential alternative treatment for patients with unresectable colorectal liver metastasis. A 65-year-old man underwent sigmoidectomy for sigmoid colon cancer with bilobar, multiple liver metastases. Postoperatively, an HAI regimen of 5-fluorouracil(5-FU, 1,000 mg/m2/5 h/every week)was administered for 26 weeks; the total dose of 5-FU administered was 52 g. Complete response(CR)was achieved, according to an imaging diagnosis technique. Thereafter, the patient was followed-up in an outpatient setting, without any further anti-cancer treatment. A solitary liver metastasis was identified by using magnetic resonance imaging(MRI), 6 years 6 months after achieving CR. The patient underwent partial liver resection for the recurrent liver metastasis. Histological diagnosis revealed an adenocarcinoma, consistent with the findings for metastatic sigmoid colon cancer. The patient's postoperative recovery was uneventful, and he remains alive 5 years after liver resection, without any evidence of tumor recurrence. Further long-term follow-up might be advisable considering the slow-growing nature of this tumor.
要旨
症例は65歳,男性。2000年11月,両葉多発肝転移を伴うS状結腸癌でS状結腸切除術を施行。術後1か月目に肝動注化学療法(5-FU 1,000 mg/m2/5時間/週)を開始。12コース終了時点では肝転移の遺残があり,計26コース終了後に完全寛解(CR)となった。以後,無化療で経過観察。2008年1月のMRIでS4に肝転移巣を同定。経上腸間膜動脈性門脈造影下CT(CTAP)で単発病変と診断し,3月に肝部分切除を施行した。病理組織学的にも大腸癌肝転移に矛盾しない像であった。肝切除後,無化療で5年を経過したが,再発兆候は認めていない。肝動注終了後6年6か月で再燃したことからslow-growingな腫瘍であると思われ,今後も長期的な経過観察が必要である。