title: [A long-term survival case of liver and mediastinal LN metastases from colon cancer treated with intensive multimodal therapy].
abstract: A 50-year-old man with multiple liver and mediastinal LN metastases from sigmoid colon cancer was admitted to our hospital in May 2005. In October 2002, a radical resection of the original tumor and liver metastases were performed at a previous hospital. Histologically, the tumor was diagnosed as Stage IV. He was treated with an oral anticancer agent as an adjuvant therapy. In January 2005, the CEA level was increased to 3.2 ng/ml and CT scan revealed a solitary liver metastasis. Partial resection of the liver was performed. On admission to our hospital, a systemic chemotherapy by FOLFOX4 was begun. The liver metastases showed 61% reduction in size and were judged to be PR. However, the intrathoracic lymph node size was not changed. Therefore, VATS extirpation of the mediastinal lymph node was performed. After 10 courses of FOLFOX4, abdominal CT revealed liver metastases remained to be almost the same size. In January 2006, radio frequency ablation (RFA) and partial hepatectomy were enforced and then, the tumor marker returned to normal. There were no serious adverse events or postoperative complications. He has been alive without any sign of recurrence for 42 months from the initial treatment. In conclusion, intensive combination therapies for remote metastases of colon cancer might be promising to obtain a long-term survival without ruining QOL.
authors.affiliation: Dept. of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University.
authors.forename: Osamu
authors.initials: O
authors.lastname: Nakahara
authors.forename: Toru
authors.initials: T
authors.lastname: Beppu
authors.forename: Takatoshi
authors.initials: T
authors.lastname: Ishiko
authors.forename: Takao
authors.initials: T
authors.lastname: Mizumoto
authors.forename: Toshiro
authors.initials: T
authors.lastname: Masuda
authors.forename: Seiji
authors.initials: S
authors.lastname: Hosaka
authors.forename: Hirohisa
authors.initials: H
authors.lastname: Okabe
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Takamori
authors.forename: Keiichiro
authors.initials: K
authors.lastname: Kanemitsu
authors.forename: Masahiko
authors.initials: M
authors.lastname: Hirota
authors.forename: Hideo
authors.initials: H
authors.lastname: Baba
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002272:Carcinoembryonic Antigen / Q000097:blood; D017024:Chemotherapy, Adjuvant; D003110:Colonic Neoplasms / Q000473:pathology*; D003131:Combined Modality Therapy; D005472:Fluorouracil / Q000627:therapeutic use; D006498:Hepatectomy; D006801:Humans; D002955:Leucovorin / Q000627:therapeutic use; D008113:Liver Neoplasms / Q000401:mortality / Q000556:secondary* / Q000628:therapy*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009944:Organoplatinum Compounds / Q000627:therapeutic use
chemical_list: D002272:Carcinoembryonic Antigen; D009944:Organoplatinum Compounds; D002955:Leucovorin; D005472:Fluorouracil