[A case of the 5-year survivor of ascending colon cancer associated with synchronous multiple liver metastasis and peritoneal dissemination successfully treated with combination therapy of systemic and hepatic arterial infusion chemotherapy].
A 67-year-old woman was diagnosed by a series of examinations as having ascending colon cancer with synchronous multiple liver metastasis. She underwent an operation after the PTPE (percutaneous transhepatic portal vein embolization) to the right lobe of the liver, as we considered that the metastatic liver tumors were all resectable. In the surgery, we identified seven peritoneal tumors and a lymph node swelling. We then pathologically diagnosed them as being peritoneal dissemination (p3) and lymph node metastasis (n2(+)). Therefore, hepatectomy was not performed, but the right hemicolectomy (D2) and insertion of an arterial infusion catheter into the hepatic artery were performed. In addition, all seven peritoneal tumors were resected. After being discharged from hospital, she was treated as an outpatient with the combination chemotherapy of systemic intravenous administration (5-fluorouracil or 5-FU, 2,500 mg/month) and hepatic arterial infusion (5-FU, 1,500 mg/week) for 16 months. Then, she continued to take tegafur uracil (300 mg/day) by mouth for 39 months. The metastatic liver tumors were gradually reduced and resulted in complete response (CR) for 20 months after the operation. She has been in remission for the past 5 years without recurrence. During the treatment, we noticed a complete atrophy that was sustained in the right lobe of the liver to which PTPE was performed. As far as hepatic arterial infusion chemotherapy is concerned, our case study was interesting and effective.
Mochizuki
Ryoyu
R
Dept. of Academic Surgery, Chiba University.
Gunji
Yoshio
Y
Takayama
Wataru
W
Miyazaki
Shiniti
S
Makino
Harufumi
H
Matsushita
Kazuyuki
K
Miyauchi
Hideaki
H
Chiba
Satoshi
S
Ochiai
Takenori
T
D000368:Aged; D000553:Ambulatory Care; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage*; D003110:Colonic Neoplasms / Q000473:pathology*; D004621:Embolization, Therapeutic; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage*; D006499:Hepatic Artery; D006801:Humans; D007261:Infusions, Intra-Arterial; D007262:Infusions, Intravenous; D008113:Liver Neoplasms / Q000556:secondary* / Q000628:therapy*; D008207:Lymphatic Metastasis; D010534:Peritoneal Neoplasms / Q000188:drug therapy* / Q000556:secondary* / Q000601:surgery
D000964:Antimetabolites, Antineoplastic; D005472:Fluorouracil