title: [Estimation of peritoneal dissemination in patients with unresectable advanced or recurrent colorectal cancer who underwent curative resection after combination chemotherapy].
abstract: In a group of 209 colorectal cancer patients with unresectable tumors, 10 patients underwent curative resection after combination chemotherapy at our hospital between 2006 and 2012. Of these 10 patients, 5 presented with peritoneal dissemination at the start of chemotherapy. With the exception of 1 patient with peritoneal recurrence, peritoneal dissemination and liver metastasis were observed in all patients at the time of diagnosis of colorectal cancer. Computed tomography (CT) and/ or positron emission tomography-CT examination revealed disappearance of peritoneal dissemination in response to chemotherapy, except in 1 patient with peritoneal recurrence. After combination chemotherapy, surgical resection of liver metastases and peritoneal dissemination was performed. Pathological and intraoperative findings indicated disappearance of peritoneal dissemination in 3 patients and P2 grade peritoneal dissemination in 1 patient. In the patient with peritoneal recurrence, 1 tumor was completely resected. Interestingly, none of the 3 patients that exhibited complete disappearance of peritoneal dissemination showed peritoneal recurrence, although 1 patient exhibited metastases in the lung and non-regional lymph nodes. In contrast, the patient with P2 grade peritoneal dissemination showed peritoneal recurrence and lung metastasis. All 5 patients survived (duration from diagnosis of colorectal cancer, 31-83 months). Herein, we report the use of combination chemotherapy to achieve the disappearance of peritoneal dissemination, changing unresectable colorectal cancer with peritoneal dissemination into resectable cancer.
authors.affiliation: Dept. of Digestive, Breast, Transplant Surgery,Hiroshima Prefectural Hospital.
authors.forename: Shinori
authors.initials: S
authors.lastname: Mizota
authors.forename: Satoshi
authors.initials: S
authors.lastname: Ikeda
authors.forename: Masami
authors.initials: M
authors.lastname: Yamauchi
authors.forename: Yuki
authors.initials: Y
authors.lastname: Imaoka
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Mashima
authors.forename: Sho
authors.initials: S
authors.lastname: Okimoto
authors.forename: Yuji
authors.initials: Y
authors.lastname: Takakura
authors.forename: Midori
authors.initials: M
authors.lastname: Noma
authors.forename: Masahiro
authors.initials: M
authors.lastname: Ohara
authors.forename: Koichi
authors.initials: K
authors.lastname: Oishi
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Kohashi
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Fudaba
authors.forename: Tatsuro
authors.initials: T
authors.lastname: Ishimoto
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Matsugu
authors.forename: Hideki
authors.initials: H
authors.lastname: Nakahara
authors.forename: Takashi
authors.initials: T
authors.lastname: Urushihara
authors.forename: Katsunori
authors.initials: K
authors.lastname: Shinozaki
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Itamoto
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D015179:Colorectal Neoplasms / Q000188:drug therapy / Q000556:secondary* / Q000601:surgery; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000188:drug therapy / Q000556:secondary; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010534:Peritoneal Neoplasms / Q000188:drug therapy / Q000556:secondary*; D012008:Recurrence