title: "En bloc" caudate lobe and inferior vena cava resection following cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for peritoneal and liver metastasis of colorectal cancer.
abstract: There are diverse protocols to manage patients with recurrent disease after primary cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) for peritoneal carcinomatosis. We describe a case of metachronous liver metastasis after CRS and HIPEC for colorectal cancer, successfully treated with a selective metastectomy and partial graft of the inferior vena cava. A 35-year-old female presented with a large tumour in the cecum and consequent colonic stenosis. After an emergency right colectomy, the patient received adjuvant chemotherapy. One year later she was diagnosed with peritoneal carcinomatosis, and it was decided to carry out a CRS/HIPEC. After 2 years of total remission, an isolated metachronous liver metastasis was detected by magnetic resonance imaging surveillance. The patient underwent a third procedure including a caudate lobe and partial inferior vena cava resection with a prosthetic graft interposition, achieving an R0 situation. The postoperative course was uneventful and the patient was discharged on postoperative day 17 after the liver resection. At 18-mo follow-up after the liver resection the patient remained free of recurrence. In selected patients, the option of re-operation due to recurrent disease should be discussed. Even liver resection of a metachronous metastasis and an extended vascular resection are acceptable after CRS/HIPEC and can be considered as a potential treatment option to remove all macroscopic lesions.
authors.affiliation: Patricia Sánchez-Velázquez, Pompiliu Piso, Department of Surgery, Barmherzige Brüder Krankenhaus Regensburg, 93049 Regensburg, Germany.
authors.forename: Patricia
authors.initials: P
authors.lastname: Sánchez-Velázquez
authors.affiliation: Patricia Sánchez-Velázquez, Pompiliu Piso, Department of Surgery, Barmherzige Brüder Krankenhaus Regensburg, 93049 Regensburg, Germany.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Moosmann
authors.affiliation: Patricia Sánchez-Velázquez, Pompiliu Piso, Department of Surgery, Barmherzige Brüder Krankenhaus Regensburg, 93049 Regensburg, Germany.
authors.forename: Ingolf
authors.initials: I
authors.lastname: Töpel
authors.affiliation: Patricia Sánchez-Velázquez, Pompiliu Piso, Department of Surgery, Barmherzige Brüder Krankenhaus Regensburg, 93049 Regensburg, Germany.
authors.forename: Pompiliu
authors.initials: P
authors.lastname: Piso
mesh_terms: D000230:Adenocarcinoma / Q000000981:diagnostic imaging / Q000556:secondary / Q000628:therapy*; D000328:Adult; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002430:Cecal Neoplasms / Q000473:pathology / Q000628:therapy*; D017024:Chemotherapy, Adjuvant; D003082:Colectomy; D015179:Colorectal Neoplasms / Q000473:pathology / Q000628:therapy*; D065426:Cytoreduction Surgical Procedures / Q000379:methods*; D005260:Female; D005472:Fluorouracil / Q000627:therapeutic use; D006498:Hepatectomy; D006801:Humans; D006979:Hyperthermia, Induced / Q000379:methods; D007263:Infusions, Parenteral; D002955:Leucovorin / Q000627:therapeutic use; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary / Q000628:therapy*; D008279:Magnetic Resonance Imaging; D059146:Metastasectomy; D009944:Organoplatinum Compounds / Q000627:therapeutic use; D010534:Peritoneal Neoplasms / Q000556:secondary / Q000628:therapy*; D014682:Vena Cava, Inferior / Q000601:surgery*
chemical_list: D000970:Antineoplastic Agents; D009944:Organoplatinum Compounds; D002955:Leucovorin; D005472:Fluorouracil
keywords: Colorectal cancer; Cytoreductive surgery; Hyperthermic intraperitoneal chemotherapy; Liver metastasis; Liver resection