内容紹介
Summary
Neoadjuvant chemoradiotherapy(NACRT)was administered at our hospital to 3 patients with lower advanced rectal cancer; NACRT resulted in pathological complete response(pCR). Case 1: A 65-year-old man was diagnosed with T4aN1M0, cStage Ⅲb disease; after chemoradiotherapy(CRT), the clinical stage improved to T4aN0M0, ycStageⅡb. Laparoscopic Hartmann's procedure and D3 lymph node dissection were performed 51 days after CRT. No recurrence was observed 31 months after surgery. Case 2: A 67-year-old man was diagnosed with T4aN2M0, cStage Ⅲb disease; after CRT, the clinical stage improved to T4aN1M0, ycStage Ⅲa. Laparoscopic abdominoperitoneal resection and D3 lymph node dissection were performed 57 days after CRT. No recurrence was observed 21 months after surgery. Case 3: An 83-year-old woman was diagnosed with T4aN2M0, cStage Ⅲb disease; after CRT, the clinical stage improved to T4aN0M0, ycStageⅡb. Laparoscopic abdominoperitoneal resection and D3 lymph node dissection were performed 64 days after CRT. No recurrence was observed 16 months after surgery. Here, we report 3 cases of lower advanced rectal cancer involving curative resection following CRT, and we provide a short literature review.
要旨
当院にて術前化学放射線療法(neoadjuvant chemoradiotherapy: NACRT)を施行し,病理学的完全奏効(pathological complete response: pCR)を得た下部進行直腸癌3例を経験した。症例1: 65歳,男性。2型病変[anal verge(AV)7cm],T4aN1M0,cStage Ⅲb。NACRTにより,T4aN0M0,ycStageⅡbまで縮小し,化学放射線療法(CRT)後51日目に腹腔鏡下ハルトマン手術+D3を施行した。術後31か月無再発経過中である。症例2: 67歳,男性。2型病変(AV 4 cm),T4aN2M0,cStage Ⅲb。NACRTでT4aN1M0,ycStage Ⅲaまで縮小し,CRT後57日目に腹腔鏡下直腸切断術+D3を施行した。術後21か月無再発経過中である。症例3: 83歳,女性。2型病変(AV 5 cm),T4aN2M0,cStage Ⅲb。NACRTでT4aN0M0,ycStageⅡbまで縮小し,CRT後64日目に腹腔鏡下直腸切断術+D3を施行した。術後16か月無再発経過中である。3症例とも良好な経過となっているが,長期予後に関しては今後のさらなる検討が必要であると考える。
目次
Neoadjuvant chemoradiotherapy(NACRT)was administered at our hospital to 3 patients with lower advanced rectal cancer; NACRT resulted in pathological complete response(pCR). Case 1: A 65-year-old man was diagnosed with T4aN1M0, cStage Ⅲb disease; after chemoradiotherapy(CRT), the clinical stage improved to T4aN0M0, ycStageⅡb. Laparoscopic Hartmann's procedure and D3 lymph node dissection were performed 51 days after CRT. No recurrence was observed 31 months after surgery. Case 2: A 67-year-old man was diagnosed with T4aN2M0, cStage Ⅲb disease; after CRT, the clinical stage improved to T4aN1M0, ycStage Ⅲa. Laparoscopic abdominoperitoneal resection and D3 lymph node dissection were performed 57 days after CRT. No recurrence was observed 21 months after surgery. Case 3: An 83-year-old woman was diagnosed with T4aN2M0, cStage Ⅲb disease; after CRT, the clinical stage improved to T4aN0M0, ycStageⅡb. Laparoscopic abdominoperitoneal resection and D3 lymph node dissection were performed 64 days after CRT. No recurrence was observed 16 months after surgery. Here, we report 3 cases of lower advanced rectal cancer involving curative resection following CRT, and we provide a short literature review.
要旨
当院にて術前化学放射線療法(neoadjuvant chemoradiotherapy: NACRT)を施行し,病理学的完全奏効(pathological complete response: pCR)を得た下部進行直腸癌3例を経験した。症例1: 65歳,男性。2型病変[anal verge(AV)7cm],T4aN1M0,cStage Ⅲb。NACRTにより,T4aN0M0,ycStageⅡbまで縮小し,化学放射線療法(CRT)後51日目に腹腔鏡下ハルトマン手術+D3を施行した。術後31か月無再発経過中である。症例2: 67歳,男性。2型病変(AV 4 cm),T4aN2M0,cStage Ⅲb。NACRTでT4aN1M0,ycStage Ⅲaまで縮小し,CRT後57日目に腹腔鏡下直腸切断術+D3を施行した。術後21か月無再発経過中である。症例3: 83歳,女性。2型病変(AV 5 cm),T4aN2M0,cStage Ⅲb。NACRTでT4aN0M0,ycStageⅡbまで縮小し,CRT後64日目に腹腔鏡下直腸切断術+D3を施行した。術後16か月無再発経過中である。3症例とも良好な経過となっているが,長期予後に関しては今後のさらなる検討が必要であると考える。