title: Successful combination therapy of radical liver resection with 5-fluorouracil/leucovorin, oxaliplatin, plus bevacizumab for ascending colon cancer with pulmonary and 43 liver metastases: report of a case.
abstract: At the time of diagnosis, 20% to 25% of patients with colorectal cancer already have liver metastases, the presence of which is a most important prognostic factor. A 64-year-old man was admitted to our hospital for investigation of anemia and multiple liver tumors. Examinations revealed ascending colon carcinoma with more than 40 liver metastases and 2 lung metastases. We performed right hemicolectomy with lymph node dissection, which was followed by 5-fluorouracil/leucovorin, oxaliplatin, plus bevacizumab (FOLFOX-BV). After 4 courses of chemotherapy, the lung metastases were in complete remission and the liver metastases had shrunk. We suggested the option of radical liver resection, but the patient declined initially as he had not suffered any severe side effects of FOLFOX-BV. After 23 courses of the chemotherapy, he agreed to undergo hepatectomy. We performed extended right lobectomy with partial left and caudal lobe resection. All of the macroscopic metastatic lesions were resected. Histopathologically, viable cancer cells were recognized in 7 of the 43 liver metastatic lesions. Postoperatively, FOLFOX-BV was restarted and continued for 10 months. At the time of writing, 15 months after the hepatectomy, the patient was well without evidence of recurrence of the cancer.
authors.affiliation: Department of Hepato-Biliary-Pancratic Surgery, Tokyo Medical and Dental University, Graduate School of Medicine, Bunkyo-ku, Tokyo, Japan. t.ochiai.msrg@tmd.ac.jp
authors.forename: Takanori
authors.initials: T
authors.lastname: Ochiai
authors.forename: Taiki
authors.initials: T
authors.lastname: Masuda
authors.forename: Masayuki
authors.initials: M
authors.lastname: Yagi
authors.forename: Reo
authors.initials: R
authors.lastname: Kasai
authors.forename: Takaki
authors.initials: T
authors.lastname: Furuyama
authors.forename: Kanako
authors.initials: K
authors.lastname: Tsukamoto
authors.forename: Hiromitsu
authors.initials: H
authors.lastname: Ito
authors.forename: Kimihiro
authors.initials: K
authors.lastname: Igari
authors.forename: Arihiro
authors.initials: A
authors.lastname: Aihara
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Kumagai
authors.forename: Michio
authors.initials: M
authors.lastname: Iida
authors.forename: Hajime
authors.initials: H
authors.lastname: Odajima
authors.forename: Shinji
authors.initials: S
authors.lastname: Tanaka
authors.forename: Shigeki
authors.initials: S
authors.lastname: Arii
authors.forename: Shigeru
authors.initials: S
authors.lastname: Yamazaki
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy / Q000556:secondary* / Q000601:surgery; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D000068258:Bevacizumab; D017024:Chemotherapy, Adjuvant; D003082:Colectomy; D044682:Colon, Ascending; D003110:Colonic Neoplasms / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery; D005472:Fluorouracil / Q000008:administration & dosage; D006498:Hepatectomy; D006801:Humans; D002955:Leucovorin / Q000008:administration & dosage; D008113:Liver Neoplasms / Q000188:drug therapy / Q000556:secondary* / Q000601:surgery; D008175:Lung Neoplasms / Q000188:drug therapy / Q000556:secondary*; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009944:Organoplatinum Compounds / Q000008:administration & dosage; D000077150:Oxaliplatin
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D009944:Organoplatinum Compounds; D000077150:Oxaliplatin; D000068258:Bevacizumab; D002955:Leucovorin; D005472:Fluorouracil