title: [A case of long-term survival due to combined modality therapy for liver metastasis of colon cancer].
abstract: The patient was a 68-year-old man. Because sigmoid colon cancer and metastatic liver cancer was diagnosed in August 2009, an indwelling central venous port and sigmoid colon resection were implemented. The metastatic liver cancer was a huge tumor occupying the right hepatic lobe and caudate lobe. In consideration of the risk associated with the resection and the possibility of early recurrence, the postoperative chemotherapy was selected. He underwent 9 courses of bevacizumab (Bev)+FOLFOX. The tumor was observed to reduce but continued to occupy the right lobe and caudate lobe. At this point, the surgical treatment was selected because the tumor has been shrunk and there is no appearance of new metastases. In order to preserve residual liver function, he underwent percutaneous transhepatic portal embolization and then resection of the right lobe of the liver in February 2010. Although the Bev+FOLFOX treatment was started again after surgery as adjuvant chemotherapy, the metastatic liver cancer recurred in the remnant liver in August 2010. Because it was about 6 months from the first recurrence of liver resection, we decided to continue chemotherapy immediately without resection. However, the chemotherapy was insufficient to shrink the tumor, which increased because it was present at 3 locations in the liver. Therefore, partial hepatectomy at the 3 locations with positron-emission tomography was performed in February 2011. Since then, chemotherapy has not been performed in patients, and there is no recurrence as of March 2012. In the guideline for the treatment of liver metastasis of colorectal cancer, even though chemotherapy is currently developed, the surgical procedure is recommended for patients who are responsive to local therapy. If the cancer recur immediately after resection, it is difficult to decide whether to re-resect. We report the case in which the tumor-free status can be observed as a result of a combination of systemic chemotherapy and local therapy.
authors.affiliation: Dept. of Surgery, Kyushu Central Hospital of the Mutual Aid Association of Public School Teachers, Japan.
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Hasegawa
authors.forename: Takashi
authors.initials: T
authors.lastname: Hashimoto
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Nakamura
authors.forename: Masaru
authors.initials: M
authors.lastname: Kitagawa
authors.forename: Kensuke
authors.initials: K
authors.lastname: Kudo
authors.forename: Fumihiro
authors.initials: F
authors.lastname: Shoji
authors.forename: Akira
authors.initials: A
authors.lastname: Kabashima
authors.forename: Seiichi
authors.initials: S
authors.lastname: Teramoto
authors.forename: Masayuki
authors.initials: M
authors.lastname: Kitamura
mesh_terms: D000368:Aged; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use*; D000068258:Bevacizumab; D003131:Combined Modality Therapy; D005472:Fluorouracil / Q000008:administration & dosage; D006498:Hepatectomy; D006801:Humans; D002955:Leucovorin / Q000008:administration & dosage; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000556:secondary / Q000601:surgery; D008297:Male; D009944:Organoplatinum Compounds / Q000008:administration & dosage; D012811:Sigmoid Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D013997:Time Factors
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D009944:Organoplatinum Compounds; D000068258:Bevacizumab; D002955:Leucovorin; D005472:Fluorouracil