title: A case of long-term survival after repeated response to oxaliplatin-based chemotherapy and repeated thermoablation of liver metastases from colorectal cancer. Should we introduce the concept of oxaliplatin-resistant tumors?
abstract: BACKGROUND
  The management of advanced colorectal cancer patients differs among cancer centers. International guidelines recommend offering all the recognized active regimens in order to obtain survival advantage, but little information is given about the sequence and combination in which such regimens should be administered.
  
  
  METHODS
  We report the case of a man with multiple liver metastasis from colorectal cancer followed for more than 78 months at our Institution. Repeated response to the same oxaliplatin, 5-fluorouracil and folinic acid chemotherapy schedule was achieved, and repeated radiofrequency ablation of liver metastases was performed until progression of lung and brain disease at 50 and 72 months, respectively, after the diagnosis of advanced disease. Although the tumor became oxaliplatin and chemo-resistant after the onset of extra-hepatic disease, a more aggressive chemotherapy regimen, including a doublet with a biological, halted tumor growth.
  
  
  CONCLUSIONS
  The patient survived for more than 78 months without experiencing a major impact on his quality of life. This case reflects the importance of following tumor biology in the therapeutic decision-making process, reintroducing oxaliplatin whenever possible, and adopting a more aggressive strategy when the tumor becomes oxaliplatin-resistant.
authors.forename: Azzurra
authors.initials: A
authors.lastname: Ottone
authors.forename: Elisa
authors.initials: E
authors.lastname: Bellini
authors.forename: Anna
authors.initials: A
authors.lastname: Ferrero
authors.forename: Chiara
authors.initials: C
authors.lastname: Baratelli
authors.forename: Eleonora
authors.initials: E
authors.lastname: Taberna
authors.forename: Raffaella
authors.initials: R
authors.lastname: Bitossi
authors.forename: Maria Pia
authors.initials: MP
authors.lastname: Brizzi
authors.forename: Marco
authors.initials: M
authors.lastname: Tampellini
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy / Q000556:secondary* / Q000601:surgery / Q000628:therapy*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001932:Brain Neoplasms / Q000556:secondary; D017115:Catheter Ablation; D018450:Disease Progression; D055870:Drug Chronotherapy; D019008:Drug Resistance, Neoplasm; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D002955:Leucovorin / Q000008:administration & dosage; D008113:Liver Neoplasms / Q000188:drug therapy / Q000556:secondary* / Q000601:surgery / Q000628:therapy*; D008175:Lung Neoplasms / Q000556:secondary; D008297:Male; D008875:Middle Aged; D009944:Organoplatinum Compounds / Q000008:administration & dosage; D000077150:Oxaliplatin; D011788:Quality of Life; D019233:Retreatment; D012811:Sigmoid Neoplasms / Q000473:pathology*; D017741:Survivors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D009944:Organoplatinum Compounds; D000077150:Oxaliplatin; D002955:Leucovorin; D005472:Fluorouracil