title: [Five-Year Recurrence-Free Survival after mFOLFOX6 Administration, Right Hemicolectomy, and Lymphadenectomy for Portal Venous Tumor Thromboembolism].
abstract: A 71-year-old woman was admitted for fever and appetite loss. She was diagnosed with ascending colon cancer, with portal vein tumor thromboembolism extending to the portosplenic junction. This was deemed unresectable despite the absence of distant metastasis. She underwent 16 courses of mFOLFOX6 therapy, and because the effect of chemotherapy was PR, right hemicolectomy with high ligation of the ileocolic vessels and the right branch of the middle colic vessels was performed. The tumor stage was yp-T3N1bM0, StageⅢB with a few remaining cancer cells in the portal venous system. Staging after chemotherapy effect was Grade 1a. Postoperatively, 13 courses of mFOLFOX6 were administered. A repeat CT scan showed lymph node recurrence along the SMV, which was subsequently resected again. After the second operation, 9 courses of the DeGramont regimen was administered and discontinued. Five years after the last operation, the patient remains well and without any recurrences. Colonic carcinoma with portal venous tumor thromboembolism has been reported in 9 cases, including ours. Among these, 8 cases involved the ascending colon. Seven of the affected patients were female while 3 were poorly differentiated adenocarcinoma. None of the other patients, except for our case, reported a 5 year patient survival rate without recurrence.
authors.affiliation: Dept. of Gastroenterological Surgery, Saitama Cancer Center.
authors.forename: Yoji
authors.initials: Y
authors.lastname: Nishimura
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Nishizawa
authors.forename: Hideki
authors.initials: H
authors.lastname: Ishikawa
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Mori
authors.forename: Michitoshi
authors.initials: M
authors.lastname: Takano
authors.forename: Takashi
authors.initials: T
authors.lastname: Takenoya
authors.forename: Masako
authors.initials: M
authors.lastname: Asayama
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Kawashima
authors.forename: Hirohiko
authors.initials: H
authors.lastname: Sakamoto
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Tanaka
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D003082:Colectomy; D044682:Colon, Ascending / Q000473:pathology* / Q000601:surgery; D003110:Colonic Neoplasms / Q000150:complications / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery; D005260:Female; D005472:Fluorouracil / Q000627:therapeutic use; D006801:Humans; D002955:Leucovorin / Q000627:therapeutic use; D008197:Lymph Node Excision; D009944:Organoplatinum Compounds / Q000627:therapeutic use; D011169:Portal Vein / Q000473:pathology*; D013997:Time Factors; D016896:Treatment Outcome; D054556:Venous Thromboembolism / Q000209:etiology*
chemical_list: D009944:Organoplatinum Compounds; D002955:Leucovorin; D005472:Fluorouracil