[Report of a successful case of multidisciplinary therapy for a patient with lung and liver metastasis from rectal adenocarcinoma].
A strategy of multidisciplinary therapy is considered necessary for the longer survival of a patient diagnosed with advanced colorectal cancer. We report a successful multi-disciplinary therapy case of a 70's-year-old male who received pulmonary resection for metastatic lung cancer twice after primary resection for rectal cancer. Solitary metastatic liver cancer with portal vein tumor thrombus (PVTT) was diagnosed 5 years and 4 months after primary surgery. Although systemic chemotherapy was started immediately, disease control was poor and local pulmonary recurrence appeared. Although intrahepatic metastasis was considered the most important prognostic factor, radiation therapy against PVTT (50 Gy) was initially performed to control disease. After verifying that no new recurrent lesions had arisen during radiation therapy, a third pulmonary resection (in the left upper remnant lobectomy)was performed. Hepatectomy(in the right lobectomy)was then performed for curative purposes. Pathological efficacy of radiation therapy to PVTT was revealed as GradeIb according to Evans' classification. In accordance with the patient's request, no adjuvant treatment was planned. Seven years after primary resection no sign of recurrence is evident. Radiation therapy is suggested to be most useful for disease control and patient selection.
Dept. of Gastroenterological Surgery, Higashiosaka City General Hospital.
Terumasa
T
Yamada
Chiwan
C
Kim
Tomo
T
Nakagawa
Kazuya
K
Hiraoka
Ken
K
Konishi
Shunji
S
Endo
Masaki
M
Okuyama
Kazuyuki
K
Oda
Masanobu
M
Hayakawa
Amane
A
Yamauchi
Junichi
J
Nishijima
D000230:Adenocarcinoma / Q000556:secondary / Q000628:therapy*; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D003131:Combined Modality Therapy; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary / Q000628:therapy*; D008175:Lung Neoplasms / Q000556:secondary / Q000628:therapy*; D008297:Male; D011013:Pneumonectomy; D012004:Rectal Neoplasms / Q000473:pathology* / Q000628:therapy; D012008:Recurrence