内容紹介
Summary
A 62-year-old man was diagnosed with liver metastasis of sigmoid colon cancer, which resulted in bowel obstruction. SOX plus bevacizumab therapy was administered to perform hepatectomy, after the artificial anus construction; however, substantial liver dysfunction occurred. Therefore, we only performed primary tumor resection and waited for improvement in liver function. After 2 months, liver function improved and liver metastasis increased. However, another metastasis was not recognized, so hepatectomy was carried out, and R0 resection was performed. The oxaliplatin-induced liver function disorder was reversible; however, preoperative chemotherapy for resectable colorectal liver metastases increases the risk of missing the resection window. It is necessary to carefully examine the tumor type and preoperative liver function.
要旨
症例は62歳,男性。排便停止,腹部膨満感を訴え受診し,検査の結果,S状結腸癌肝転移と診断した。人工肛門造設後,SOX+bevacizumab療法を4コース施行後に肝切除の方針としたが,著明な肝機能低下を認めたため原発巣切除のみ行い,肝機能の改善を待った。2か月で肝機能は改善し,その間に肝転移巣は増大したが新規転移は認めなかったため,肝切除を行いR0切除し得た。oxaliplatinによる肝機能障害は可逆性であったが,切除可能な大腸癌肝転移に対する術前化学療法は切除のタイミングを逸する危険があり,症例の適応,術前肝機能については慎重に検討する必要があると思われる。
目次
A 62-year-old man was diagnosed with liver metastasis of sigmoid colon cancer, which resulted in bowel obstruction. SOX plus bevacizumab therapy was administered to perform hepatectomy, after the artificial anus construction; however, substantial liver dysfunction occurred. Therefore, we only performed primary tumor resection and waited for improvement in liver function. After 2 months, liver function improved and liver metastasis increased. However, another metastasis was not recognized, so hepatectomy was carried out, and R0 resection was performed. The oxaliplatin-induced liver function disorder was reversible; however, preoperative chemotherapy for resectable colorectal liver metastases increases the risk of missing the resection window. It is necessary to carefully examine the tumor type and preoperative liver function.
要旨
症例は62歳,男性。排便停止,腹部膨満感を訴え受診し,検査の結果,S状結腸癌肝転移と診断した。人工肛門造設後,SOX+bevacizumab療法を4コース施行後に肝切除の方針としたが,著明な肝機能低下を認めたため原発巣切除のみ行い,肝機能の改善を待った。2か月で肝機能は改善し,その間に肝転移巣は増大したが新規転移は認めなかったため,肝切除を行いR0切除し得た。oxaliplatinによる肝機能障害は可逆性であったが,切除可能な大腸癌肝転移に対する術前化学療法は切除のタイミングを逸する危険があり,症例の適応,術前肝機能については慎重に検討する必要があると思われる。