内容紹介
Summary
A 60s man was diagnosed with unresectable advanced rectal cancer with synchronous solitary liver metastasis. Chemotherapy was administered and the primary tumor shrank immediately. However, he still demonstrated dorsal extension; therefore, chemotherapy was continued for approximately 1 year. After long-term chemotherapy, the primary tumor was deemed to be resectable because the dorsal extension had decreased. We achieved curative resection by performing a primary tumor and liver resection and he has shown no recurrence without adjuvant chemotherapy. Although the primary tumor was initially diagnosed as unresectable, it is important to consider the potential for curative resection after long-term chemotherapy.
要旨
症例は60歳台,男性。同時性単発肝転移を伴った局所進行直腸癌に対し,原発巣切除不能の判断にて化学療法を導入した。原発巣は縮小したが,依然として仙骨前面への伸展を認め切除不能と判断し,さらに化学療法を継続した。約1年間の化学療法にて仙骨前面の伸展が軽減し原発巣切除可能と判断し,転移巣も併せて二期的に手術を施行した。治癒切除となり,術後化学療法なく8か月無再発生存中である。いったんは切除不能と判断した症例においても治療効果を評価しながら根治手術の可能性を考慮し,適切な治療方針を選択していくことが重要と考える。
目次
A 60s man was diagnosed with unresectable advanced rectal cancer with synchronous solitary liver metastasis. Chemotherapy was administered and the primary tumor shrank immediately. However, he still demonstrated dorsal extension; therefore, chemotherapy was continued for approximately 1 year. After long-term chemotherapy, the primary tumor was deemed to be resectable because the dorsal extension had decreased. We achieved curative resection by performing a primary tumor and liver resection and he has shown no recurrence without adjuvant chemotherapy. Although the primary tumor was initially diagnosed as unresectable, it is important to consider the potential for curative resection after long-term chemotherapy.
要旨
症例は60歳台,男性。同時性単発肝転移を伴った局所進行直腸癌に対し,原発巣切除不能の判断にて化学療法を導入した。原発巣は縮小したが,依然として仙骨前面への伸展を認め切除不能と判断し,さらに化学療法を継続した。約1年間の化学療法にて仙骨前面の伸展が軽減し原発巣切除可能と判断し,転移巣も併せて二期的に手術を施行した。治癒切除となり,術後化学療法なく8か月無再発生存中である。いったんは切除不能と判断した症例においても治療効果を評価しながら根治手術の可能性を考慮し,適切な治療方針を選択していくことが重要と考える。