[A case of liver metastasis from sigmoid colon cancer treated effectively by second-line chemotherapy].

Abstract

A case of successful chemotherapy for a metachronous liver metastasis following resection for sigmoid colon cancer is presented. A 51-year-old man underwent sigmoidectomy, ileocecal resection, and descending colon colostomy for sigmoid colon cancer with ileum invasion. Six courses of FOLFOX4 were performed as adjuvant chemotherapy. One year after sigmoidectomy, a liver metastasis was detected on computed tomography (CT) examination. Chemotherapy with FOLFOX+bevacizumab was restarted. Three courses were administered, but hepatic dysfunction occurred after the second and third courses, and FOLFOX was discontinued. Subsequent chemotherapy was reinitiated with FOLFIRI+bevacizumab. After 9 courses, the carcinoembryonic antigen level was normalized and appeared to be decreased by imaging studies. Upon the patient's request, only oral S-1 was administered. After 2 courses, CT revealed that the diameter of the tumor had increased by 2 cm. Therefore, right lobectomy of the liver, colostomy closure, and anastomosis were performed. During these procedures, a nodule was found in the omentum and was removed. Rapid intra-operative diagnosis revealed peritoneal dissemination. The pathological diagnosis was liver metastasis of sigmoid colon cancer, with necrosis and fibrosis seen in approximately one-half of specimens. The surgical margins were negative. Neither metastatic cancer nor dissemination were found in the resected greater omentum.

• Authors: Kentaro Gokita, Katsunori Ami, Yutaro Matsunaga, Keiichi Fujiya, Nana Ohshima, Hidetoshi Amagasa, Hideaki Ganno, Kenichiro Imai, Akira Fukuda, Takeshi Nagahama, Masayuki Ando, Hidetaka Akita, Shikofumi Tei, Youichi Okada, Kuniyoshi Arai
• Journal: Gan to kagaku ryoho. Cancer & chemotherapy (Gan To Kagaku Ryoho) Vol. 41 Issue 12 Pg. 1761-3 (Nov 2014) ISSN: 0385-0684 [Print] Japan
• PMID: 25731321 (Publication Type: Case Reports, English Abstract, Journal Article)

Chemical References

• Antibodies, Monoclonal, Humanized
• Bevacizumab
• Leucovorin
• Fluorouracil
• Camptothecin

Topics

• Antibodies, Monoclonal, Humanized (administration & dosage)
• Antineoplastic Combined Chemotherapy Protocols (administration & dosage, therapeutic use)
• Bevacizumab
• Camptothecin (administration & dosage, analogs & derivatives)
• Fluorouracil (administration & dosage)
• Humans
• Leucovorin (administration & dosage)
• Liver Neoplasms (drug therapy, secondary, surgery)
• Magnetic Resonance Imaging
• Male
• Middle Aged
• Multimodal Imaging
• Sigmoid Neoplasms (drug therapy, pathology, surgery)
• Tomography, X-Ray Computed
• Treatment Outcome