内容紹介
Summary
Case 1: A 60-year-old man underwent resection of a brain tumor, which was pathologically diagnosed as adenocarcinoma. As he was diagnosed with unresectable rectal cancer due to pulmonary metastasis, we performed abdominoperineal resection after chemotherapy. Since pulmonary metastasis and local recurrence were detected 1 year after the surgery, he was administered chemotherapy. He died 37 months after the surgery. Case 2: A 64-year-old man was diagnosed with unresectable rectal cancer due to pulmonary and hepatic metastases, resulting in an examination for melena. We performed laparoscopic low anterior resection and hepatic partial resection after chemotherapy. No relapse has occurred 1 year after the surgery. Case 3: A 39-year-old man was examined for abdominal pain and distension and was diagnosed with unresectable rectal cancer due to invasion of the left ureter and multiple hepatic metastases. We performed anterior resection, hepatic partial resection, and RFA after chemotherapy. He has remained in relapse-free survival for 15 months after the surgery. These results suggest that curative resection after chemotherapy improves the prognosis of unresectable colorectal cancer.
要旨
症例1は60歳,男性。脳外科にて脳腫瘍に対して手術を施行したところ,病理結果より腺癌の診断であった。精査にて肺転移を伴う切除不能直腸癌の診断であったため,化学療法施行後に腹会陰式直腸切断術を施行した。術後1年目に多発肺転移,局所再発を認めたため化学療法を導入した。術後37か月目に死亡した。症例2は64歳,男性。血便の精査にて直腸癌,肺転移,多発肝転移の診断で根治切除不能と判断し,化学療法を施行後に腹腔鏡下低位前方切除術+肝部分切除術を施行した。術後1年,無再発生存中である。症例3は39歳,男性。腹痛,腹部膨満にて精査したところ,直腸癌,左尿管浸潤,多発肝転移の診断で切除不能と診断し,化学療法を施行後に低位前方切除術+肝部分切除術+ラジオ波焼灼療法を施行した。術後15か月で無再発生存中である。切除不能大腸癌に対して,化学療法施行後に治癒切除をめざすことで予後改善が期待できると考えられた。
目次
Case 1: A 60-year-old man underwent resection of a brain tumor, which was pathologically diagnosed as adenocarcinoma. As he was diagnosed with unresectable rectal cancer due to pulmonary metastasis, we performed abdominoperineal resection after chemotherapy. Since pulmonary metastasis and local recurrence were detected 1 year after the surgery, he was administered chemotherapy. He died 37 months after the surgery. Case 2: A 64-year-old man was diagnosed with unresectable rectal cancer due to pulmonary and hepatic metastases, resulting in an examination for melena. We performed laparoscopic low anterior resection and hepatic partial resection after chemotherapy. No relapse has occurred 1 year after the surgery. Case 3: A 39-year-old man was examined for abdominal pain and distension and was diagnosed with unresectable rectal cancer due to invasion of the left ureter and multiple hepatic metastases. We performed anterior resection, hepatic partial resection, and RFA after chemotherapy. He has remained in relapse-free survival for 15 months after the surgery. These results suggest that curative resection after chemotherapy improves the prognosis of unresectable colorectal cancer.
要旨
症例1は60歳,男性。脳外科にて脳腫瘍に対して手術を施行したところ,病理結果より腺癌の診断であった。精査にて肺転移を伴う切除不能直腸癌の診断であったため,化学療法施行後に腹会陰式直腸切断術を施行した。術後1年目に多発肺転移,局所再発を認めたため化学療法を導入した。術後37か月目に死亡した。症例2は64歳,男性。血便の精査にて直腸癌,肺転移,多発肝転移の診断で根治切除不能と判断し,化学療法を施行後に腹腔鏡下低位前方切除術+肝部分切除術を施行した。術後1年,無再発生存中である。症例3は39歳,男性。腹痛,腹部膨満にて精査したところ,直腸癌,左尿管浸潤,多発肝転移の診断で切除不能と診断し,化学療法を施行後に低位前方切除術+肝部分切除術+ラジオ波焼灼療法を施行した。術後15か月で無再発生存中である。切除不能大腸癌に対して,化学療法施行後に治癒切除をめざすことで予後改善が期待できると考えられた。