A complex oncosurgical approach to increasing the resectability of colorectal cancer metastases - a case report.
OBJECTIVE
In this case report, the authors aim to demonstrate the success of recent methods in the radical treatment of a patient with primary inoperable liver and subsequent colorectal cancer pulmonary metastases.


METHODS
A 75 year old patient with inoperable bulky metastasis in the right hepatic lobe and insufficient future remnant liver volume was indicated for a stage procedure in the liver parenchyma. Embolization of the right branch of the portal vein was first performed with subsequent administration of stem cells into the contralateral liver lobe. Following compensatory growth of the left liver lobe, right-sided hepatectomy was performed with subsequent adjuvant oncological treatment. Six months after the surgery, a metastasis developed in the right pulmonary lobe which was solved by metastasectomy.


RESULTS
The patient, one year after the diagnosis of inoperable liver metastasis, is completely healthy and free of signs of disease recurrence.


CONCLUSIONS
A comprehensive oncosurgical approach using up-to-date diagnostic and treatment options may offer patients with metastatic colorectal cancer, radical treatment with the hope of long-term quality survival.
Department of Surgery, University Hospital and Medical Faculty in Pilsen, Czech Republic.
Vladislav
V
Treska
Jarmil
J
Safranek
Daniel
D
Lysak
Hynek
H
Mirka
Tomas
T
Skalicky
Frantisek
F
Slauf
Ondrej
O
Hes
D000230:Adenocarcinoma / Q000556:secondary / Q000628:therapy*; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D015179:Colorectal Neoplasms / Q000473:pathology* / Q000601:surgery; D004621:Embolization, Therapeutic; D005472:Fluorouracil / Q000627:therapeutic use; D018380:Hematopoietic Stem Cell Transplantation; D006498:Hepatectomy; D006801:Humans; D002955:Leucovorin / Q000627:therapeutic use; D008113:Liver Neoplasms / Q000556:secondary / Q000628:therapy*; D008115:Liver Regeneration; D008175:Lung Neoplasms / Q000556:secondary / Q000601:surgery*; D008297:Male; D009944:Organoplatinum Compounds / Q000627:therapeutic use; D011013:Pneumonectomy
D009944:Organoplatinum Compounds; D002955:Leucovorin; D005472:Fluorouracil