Laparoscopic abdominosacral resection for locally advanced primary rectal cancer after treatment with mFOLFOX6 plus bevacizumab, followed by preoperative chemoradiotherapy.
Abdominosacral resection may be the only curative procedure for locally advanced rectal cancer involving the presacral fascia or sacrum. Multimodal therapy might be necessary to prevent local and distant recurrence for such tumors. A 67-year-old man was diagnosed with locally advanced rectal cancer widely involving the right pelvic sidewall and presacral fascia near the S4/5 junction on the right posterolateral side. We performed laparoscopic abdominosacral resection (S4/5) with en bloc right lateral lymph node dissection and seminal vesicle resection to obtain a clear resection margin after systemic chemotherapy with mFOLFOX6 (oxaliplatin, leucovorin, and 5-fluorouracil) plus bevacizumab, followed by preoperative chemoradiotherapy. The total operative time was 660 min, and the estimated blood loss was 550 mL. The final pathological findings revealed no residual cancer cells (pathological complete response). Laparoscopic abdominosacral resection appears to be safe and feasible in selected patients.
Gastroenterological Center, Department of Gastroenterological Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan.
Toshiya
T
Nagasaki
Takashi
T
Akiyoshi
Masashi
M
Ueno
Yosuke
Y
Fukunaga
Satoshi
S
Nagayama
Yoshiya
Y
Fujimoto
Tsuyoshi
T
Konishi
Toshiharu
T
Yamaguchi
D000005:Abdomen / Q000601:surgery*; D000230:Adenocarcinoma / Q000601:surgery* / Q000628:therapy; D000368:Aged; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage; D000970:Antineoplastic Agents / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D000068258:Bevacizumab; D059186:Chemoradiotherapy, Adjuvant; D017024:Chemotherapy, Adjuvant; D005472:Fluorouracil / Q000627:therapeutic use; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D002955:Leucovorin / Q000627:therapeutic use; D008297:Male; D020360:Neoadjuvant Therapy; D009944:Organoplatinum Compounds / Q000627:therapeutic use; D012004:Rectal Neoplasms / Q000601:surgery* / Q000628:therapy; D012007:Rectum / Q000601:surgery*; D012447:Sacrum / Q000601:surgery*
D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents; D009944:Organoplatinum Compounds; D000068258:Bevacizumab; D002955:Leucovorin; D005472:Fluorouracil
Advanced rectal cancer; laparoscopic abdominosacral resection; laparoscopic surgery