[Surgical curative resection after chemotherapy and portal vein embolization for multiple liver metastases of rectal cancer - report of a case].
A 34 -year-old woman presenting with bloody stools was diagnosed with a rectal tumor. Computed tomography (CT) revealed multiple liver masses in Couinaud segments IV, V, and VII. The lesions were diagnosed as multiple liver metastases from rectal cancer. Right trisegmentectomy of the liver was considered the optimal treatment option for curative resection; however, liver volumetric examination using CT estimated that the remnant liver volume after right trisegmentectomy would be only 24.6% of the total liver volume. Therefore, she underwent resection of the primary lesion followed by systemic chemotherapy for multiple liver metastases. She showed a partial response, according to the Response Evaluation Criteria in Solid Tumors, after 5 courses of capecitabine/oxaliplatin plus bevacizumab. Embolization of the right branch of the portal vein was performed to increase liver volume. Asubsequent liver volumetric examination with CT estimated that the remnant liver volume after right trisegmentectomy would be 38.4% of the total liver volume. Therefore, she underwent right trisegmentectomy of the liver for curative resection of the liver metastases. She had had no signs of recurrence at 3 years and 6 months after initial surgery.
Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences.
Shinnosuke
S
Hotta
Hitoshi
H
Nogami
Mae
M
Nakano
Masato
M
Nakano
Yoshifumi
Y
Shimada
Hitoshi
H
Kameyama
Jun
J
Sakata
Takashi
T
Kobayashi
Masahiro
M
Minagawa
Shinichi
S
Kosugi
Yu
Y
Koyama
Toshifumi
T
Wakai
D000328:Adult; D003131:Combined Modality Therapy; D004621:Embolization, Therapeutic; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary / Q000628:therapy*; D011169:Portal Vein / Q000473:pathology; D012004:Rectal Neoplasms / Q000473:pathology / Q000601:surgery; D014057:Tomography, X-Ray Computed