内容紹介
Three Long-Surviving Cases of Peritoneal Metastasis after Colorectal Cancer Resection
Summary
We experienced 3 impressive colorectal cancer patients who developed peritoneal recurrences and underwent surgery several times and survived for more than 5 years. Case No. 1 was of a 44-year-old woman who underwent right hemicolectomy for her stageⅡA ascending colon cancer. She developed left ovarian metastasis, which was resected 3 years later. Five years later, she developed a pelvic peritoneal recurrence, which was resected successfully. Thirteen years later, she is doing well. Case No. 2 was of a 61-year-old man who underwent transverse colectomy for his stageⅡB colon cancer. He developed ileus 2 years 9 months later due to peritoneal recurrence, which was removed successfully. He underwent another resection for peritoneal metastasis 2 years 6 months later. He was administered 15 courses of FOLFOX6. He has remained cancer-free since 2009. Case No. 3 was of a 62-year-old man who underwent sigmoidectomy for his stageⅡA colon cancer. One year 8 months later, he underwent resection for a painful abdominal wall metastasis. Eight months later, he developed another abdominal wall recurrence, which was resected successfully. He underwent thoracoscopic resection 4 times for lung metastases and was given 16 courses of FOLFOX6. In 2009, he developed pelvic peritoneal nodules, which were resected. He later needed lymphadenectomy twice. He has remained cancer-free for the last 5 years and 6 months. Curative resection must be performed for a patient with peritoneal recurrence of colorectal cancer when surgery is indicated.
要旨
大腸癌切除後の腹膜播種再発に対する手術を積極的に実施し,印象に残った3症例を提示する。症例1: 初回手術時44歳,女性。上行結腸癌で右半結腸切除を施行した。tub1,pT3N0M0,stageⅡAであった。3年後,左卵巣転移を摘出した。その5年後,ダグラス窩再発で切除した。最終手術から13年,再々発なし。症例2: 初回手術時61歳,男性。下血で発症の横行結腸癌(tub1,pT4aN0M0,stageⅡB)を切除した。2年9か月後,腹膜播種で腸閉塞となり切除した。その2年6か月後,空腸に腹膜播種が出現し部分切除した。FOLFOX6を15コース施行した。最終手術から8年,再発なし。症例3: 初回手術時62歳,男性。S状結腸癌(tub2,pT3N0M0,stageⅡA)を切除した。1年8か月後,有痛性の腹壁再発を切除した。その8か月後,腹壁に再々発し切除した。肺転移を計4回切除し,FOLFOX6を16コース投与した。3年後,骨盤右側壁再発を切除した。さらに2回リンパ節再発を切除し,最終手術から5年6か月,再発なし。大腸癌治療で重要なことは遺残なく切除し,適応があれば何度でも切除を考慮することであると考える。
目次
Summary
We experienced 3 impressive colorectal cancer patients who developed peritoneal recurrences and underwent surgery several times and survived for more than 5 years. Case No. 1 was of a 44-year-old woman who underwent right hemicolectomy for her stageⅡA ascending colon cancer. She developed left ovarian metastasis, which was resected 3 years later. Five years later, she developed a pelvic peritoneal recurrence, which was resected successfully. Thirteen years later, she is doing well. Case No. 2 was of a 61-year-old man who underwent transverse colectomy for his stageⅡB colon cancer. He developed ileus 2 years 9 months later due to peritoneal recurrence, which was removed successfully. He underwent another resection for peritoneal metastasis 2 years 6 months later. He was administered 15 courses of FOLFOX6. He has remained cancer-free since 2009. Case No. 3 was of a 62-year-old man who underwent sigmoidectomy for his stageⅡA colon cancer. One year 8 months later, he underwent resection for a painful abdominal wall metastasis. Eight months later, he developed another abdominal wall recurrence, which was resected successfully. He underwent thoracoscopic resection 4 times for lung metastases and was given 16 courses of FOLFOX6. In 2009, he developed pelvic peritoneal nodules, which were resected. He later needed lymphadenectomy twice. He has remained cancer-free for the last 5 years and 6 months. Curative resection must be performed for a patient with peritoneal recurrence of colorectal cancer when surgery is indicated.
要旨
大腸癌切除後の腹膜播種再発に対する手術を積極的に実施し,印象に残った3症例を提示する。症例1: 初回手術時44歳,女性。上行結腸癌で右半結腸切除を施行した。tub1,pT3N0M0,stageⅡAであった。3年後,左卵巣転移を摘出した。その5年後,ダグラス窩再発で切除した。最終手術から13年,再々発なし。症例2: 初回手術時61歳,男性。下血で発症の横行結腸癌(tub1,pT4aN0M0,stageⅡB)を切除した。2年9か月後,腹膜播種で腸閉塞となり切除した。その2年6か月後,空腸に腹膜播種が出現し部分切除した。FOLFOX6を15コース施行した。最終手術から8年,再発なし。症例3: 初回手術時62歳,男性。S状結腸癌(tub2,pT3N0M0,stageⅡA)を切除した。1年8か月後,有痛性の腹壁再発を切除した。その8か月後,腹壁に再々発し切除した。肺転移を計4回切除し,FOLFOX6を16コース投与した。3年後,骨盤右側壁再発を切除した。さらに2回リンパ節再発を切除し,最終手術から5年6か月,再発なし。大腸癌治療で重要なことは遺残なく切除し,適応があれば何度でも切除を考慮することであると考える。