title: Successful treatment of conversion chemotherapy for initially unresectable synchronous colorectal liver metastasis.
abstract: A 72-year-old woman with a sigmoid colon cancer and a synchronous colorectal liver metastasis (CRLM), which involved the right hepatic vein (RHV) and the inferior vena cava (IVC), was referred to our hospital. The metastatic lesion was diagnosed as initially unresectable because of its invasion into the confluence of the RHV and IVC. After she had undergone laparoscopic sigmoidectomy for the original tumor, she consequently had 3 courses of modified 5-fluorouracil, leucovorin, and oxaliplatin (mFOLFOX6) plus cetuximab. Computed tomography revealed a partial response, and the confluence of the RHV and IVC got free from cancer invasion. After 3 additional courses of mFOLFOX6 plus cetuximab, preoperative percutaneous transhepatic portal vein embolization (PTPE) was performed to secure the future remnant liver volume. Finally, a right hemihepatectomy was performed. The postoperative course was uneventful. The patient was discharged from the hospital on postoperative day 13. She had neither local recurrence nor distant metastasis 18 mo after the last surgical intervention. This multidisciplinary strategy, consisting of conversion chemotherapy using FOLFOX plus cetuximab and PTPE, could contribute in facilitating curative hepatic resection for initially unresectable CRLM.
authors: Kenta Baba, Akihiko Oshita, Mohei Kohyama, Satoshi Inoue, Yuta Kuroo, Takuro Yamaguchi, Hiroyuki Nakamura, Yoichi Sugiyama, Tatsuya Tazaki, Masaru Sasaki, Yuji Imamura, Atsushi Nakamitsu, Department of Surgery, JA Hiroshima General Hospital, Hiroshima 738-8503, Japan.
authors: Kenta
authors: K
authors: Baba
authors: Kenta Baba, Akihiko Oshita, Mohei Kohyama, Satoshi Inoue, Yuta Kuroo, Takuro Yamaguchi, Hiroyuki Nakamura, Yoichi Sugiyama, Tatsuya Tazaki, Masaru Sasaki, Yuji Imamura, Atsushi Nakamitsu, Department of Surgery, JA Hiroshima General Hospital, Hiroshima 738-8503, Japan.
authors: Akihiko
authors: A
authors: Oshita
authors: Kenta Baba, Akihiko Oshita, Mohei Kohyama, Satoshi Inoue, Yuta Kuroo, Takuro Yamaguchi, Hiroyuki Nakamura, Yoichi Sugiyama, Tatsuya Tazaki, Masaru Sasaki, Yuji Imamura, Atsushi Nakamitsu, Department of Surgery, JA Hiroshima General Hospital, Hiroshima 738-8503, Japan.
authors: Mohei
authors: M
authors: Kohyama
authors: Kenta Baba, Akihiko Oshita, Mohei Kohyama, Satoshi Inoue, Yuta Kuroo, Takuro Yamaguchi, Hiroyuki Nakamura, Yoichi Sugiyama, Tatsuya Tazaki, Masaru Sasaki, Yuji Imamura, Atsushi Nakamitsu, Department of Surgery, JA Hiroshima General Hospital, Hiroshima 738-8503, Japan.
authors: Satoshi
authors: S
authors: Inoue
authors: Kenta Baba, Akihiko Oshita, Mohei Kohyama, Satoshi Inoue, Yuta Kuroo, Takuro Yamaguchi, Hiroyuki Nakamura, Yoichi Sugiyama, Tatsuya Tazaki, Masaru Sasaki, Yuji Imamura, Atsushi Nakamitsu, Department of Surgery, JA Hiroshima General Hospital, Hiroshima 738-8503, Japan.
authors: Yuta
authors: Y
authors: Kuroo
authors: Kenta Baba, Akihiko Oshita, Mohei Kohyama, Satoshi Inoue, Yuta Kuroo, Takuro Yamaguchi, Hiroyuki Nakamura, Yoichi Sugiyama, Tatsuya Tazaki, Masaru Sasaki, Yuji Imamura, Atsushi Nakamitsu, Department of Surgery, JA Hiroshima General Hospital, Hiroshima 738-8503, Japan.
authors: Takuro
authors: T
authors: Yamaguchi
authors: Kenta Baba, Akihiko Oshita, Mohei Kohyama, Satoshi Inoue, Yuta Kuroo, Takuro Yamaguchi, Hiroyuki Nakamura, Yoichi Sugiyama, Tatsuya Tazaki, Masaru Sasaki, Yuji Imamura, Atsushi Nakamitsu, Department of Surgery, JA Hiroshima General Hospital, Hiroshima 738-8503, Japan.
authors: Hiroyuki
authors: H
authors: Nakamura
authors: Kenta Baba, Akihiko Oshita, Mohei Kohyama, Satoshi Inoue, Yuta Kuroo, Takuro Yamaguchi, Hiroyuki Nakamura, Yoichi Sugiyama, Tatsuya Tazaki, Masaru Sasaki, Yuji Imamura, Atsushi Nakamitsu, Department of Surgery, JA Hiroshima General Hospital, Hiroshima 738-8503, Japan.
authors: Yoichi
authors: Y
authors: Sugiyama
authors: Kenta Baba, Akihiko Oshita, Mohei Kohyama, Satoshi Inoue, Yuta Kuroo, Takuro Yamaguchi, Hiroyuki Nakamura, Yoichi Sugiyama, Tatsuya Tazaki, Masaru Sasaki, Yuji Imamura, Atsushi Nakamitsu, Department of Surgery, JA Hiroshima General Hospital, Hiroshima 738-8503, Japan.
authors: Tatsuya
authors: T
authors: Tazaki
authors: Kenta Baba, Akihiko Oshita, Mohei Kohyama, Satoshi Inoue, Yuta Kuroo, Takuro Yamaguchi, Hiroyuki Nakamura, Yoichi Sugiyama, Tatsuya Tazaki, Masaru Sasaki, Yuji Imamura, Atsushi Nakamitsu, Department of Surgery, JA Hiroshima General Hospital, Hiroshima 738-8503, Japan.
authors: Masaru
authors: M
authors: Sasaki
authors: Kenta Baba, Akihiko Oshita, Mohei Kohyama, Satoshi Inoue, Yuta Kuroo, Takuro Yamaguchi, Hiroyuki Nakamura, Yoichi Sugiyama, Tatsuya Tazaki, Masaru Sasaki, Yuji Imamura, Atsushi Nakamitsu, Department of Surgery, JA Hiroshima General Hospital, Hiroshima 738-8503, Japan.
authors: Yuji
authors: Y
authors: Imamura
authors: Kenta Baba, Akihiko Oshita, Mohei Kohyama, Satoshi Inoue, Yuta Kuroo, Takuro Yamaguchi, Hiroyuki Nakamura, Yoichi Sugiyama, Tatsuya Tazaki, Masaru Sasaki, Yuji Imamura, Atsushi Nakamitsu, Department of Surgery, JA Hiroshima General Hospital, Hiroshima 738-8503, Japan.
authors: Yutaka
authors: Y
authors: Daimaru
authors: Kenta Baba, Akihiko Oshita, Mohei Kohyama, Satoshi Inoue, Yuta Kuroo, Takuro Yamaguchi, Hiroyuki Nakamura, Yoichi Sugiyama, Tatsuya Tazaki, Masaru Sasaki, Yuji Imamura, Atsushi Nakamitsu, Department of Surgery, JA Hiroshima General Hospital, Hiroshima 738-8503, Japan.
authors: Hideki
authors: H
authors: Ohdan
authors: Kenta Baba, Akihiko Oshita, Mohei Kohyama, Satoshi Inoue, Yuta Kuroo, Takuro Yamaguchi, Hiroyuki Nakamura, Yoichi Sugiyama, Tatsuya Tazaki, Masaru Sasaki, Yuji Imamura, Atsushi Nakamitsu, Department of Surgery, JA Hiroshima General Hospital, Hiroshima 738-8503, Japan.
authors: Atsushi
authors: A
authors: Nakamitsu
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy / Q000556:secondary* / Q000601:surgery / Q000628:therapy*; D000368:Aged; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001706:Biopsy; D000068818:Cetuximab; D017024:Chemotherapy, Adjuvant; D002763:Cholecystectomy; D015179:Colorectal Neoplasms / Q000473:pathology*; D004621:Embolization, Therapeutic; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006498:Hepatectomy; D006801:Humans; D002955:Leucovorin / Q000008:administration & dosage; D008113:Liver Neoplasms / Q000188:drug therapy / Q000556:secondary* / Q000601:surgery / Q000628:therapy*; D020360:Neoadjuvant Therapy; D009361:Neoplasm Invasiveness; D009944:Organoplatinum Compounds / Q000008:administration & dosage; D000077150:Oxaliplatin; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D009944:Organoplatinum Compounds; D000077150:Oxaliplatin; D000068818:Cetuximab; D002955:Leucovorin; D005472:Fluorouracil
keywords: Cetuximab; Colorectal liver metastasis; Conversion chemotherapy; Initially unresectable; Percutaneous transhepatic portal vein embolization