title: [Long-Term Multidisciplinary Therapy for Multiple Liver Metastases from Colorectal Cancer with Biliary Drainage for Occlusive Jaundice--A Case Report].
abstract: Here, we report the case of a 43-year-old man who was diagnosed with sigmoid colon cancer with synchronous multiple liver metastases following resection of a primary lesion. Subsequent mFOLFOX+BV therapy elicited a marked response in the liver metastases, which led to the patient undergoing hepatic (S7) radiofrequency ablation (RFA), hepatic resection (lateral segmentectomy and partial [S5] resection), and cholecystectomy. Six months later, transluminal RFA was repeated because liver (S7) metastasis recurred, and 8 courses of XELOX plus BV therapy were administered. As obstructive jaundice due to recurrence of the liver metastases developed after a 6 months hiatus in chemotherapy, we endoscopically inserted a biliary stent. Despite reducing IRIS plus BV therapy, obstructive jaundice developed again, and 3 intrahepatic biliary stents were inserted with percutaneous transhepatic biliary drainage. To date, the patient has been alive for 4 years since the initial resection of the primary lesion after undergoing consecutive systemic chemotherapy with different regimens. Some studies have shown that in cases of obstructive jaundice caused by advanced gastrointestinal cancer, longer survival could be expected by reducing the severity of jaundice, suggesting that resuming chemotherapy as well as improving the severity of jaundice could contribute to better outcomes. The patient in the present case was successfully treated twice with biliary drainage for occlusive jaundice and chemotherapy, suggesting that a combination of multidisciplinary therapy and adequate local therapy such as biliary drainage could be important for the treatment of metastatic liver cancer.
authors.affiliation: Dept. of Surgery, Suita Municipal Hospital.
authors.forename: Shu
authors.initials: S
authors.lastname: Okamura
authors.forename: Koji
authors.initials: K
authors.lastname: Mikami
authors.forename: Kohei
authors.initials: K
authors.lastname: Murata
authors.forename: Yoichirou
authors.initials: Y
authors.lastname: Nushijima
authors.forename: Kazuyuki
authors.initials: K
authors.lastname: Okada
authors.forename: Tetsu
authors.initials: T
authors.lastname: Yanagisawa
authors.forename: Nariaki
authors.initials: N
authors.lastname: Fukuchi
authors.forename: Chikara
authors.initials: C
authors.lastname: Ebisui
authors.forename: Hideoki
authors.initials: H
authors.lastname: Yokouchi
authors.forename: Masakatsu
authors.initials: M
authors.lastname: Kinuta
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D017115:Catheter Ablation; D003131:Combined Modality Therapy; D004322:Drainage; D006801:Humans; D041781:Jaundice, Obstructive / Q000209:etiology / Q000628:therapy*; D008113:Liver Neoplasms / Q000556:secondary / Q000628:therapy*; D008297:Male; D011379:Prognosis; D012811:Sigmoid Neoplasms / Q000473:pathology / Q000628:therapy*; D013997:Time Factors