[A Case of a"Watch and Wait Therapy"Approach after Preoperative Chemoradiotherapy for Rectal Cancer Accompanied by Severe Emphysema].

Abstract

A 72-year-old man was referred to our hospital for treatment for rectal cancer. Digital rectal examination and colonoscopy revealed a 4 cm tumor located at the anterior rectal wall 5 cm away from the anal verge, and pathological examination confirmed that the tumor was adenocarcinoma. A computed tomography scan detected neither regional lymph node metastasis nor distant metastasis. Hence, he was diagnosed with cT3N0M0, cStage Ⅱa rectal cancer. The preoperative general examination revealed bradyarrhythmia and severe emphysema, and he was considered to be high risk for general anesthesia. After placement of a pacemaker, preoperative capecitabine-based chemoradiotherapy(CRT)(50.4 Gy in 28 fractions of 1.8 Gy each)was implemented. The digital rectal examination and imaging evaluation 4 weeks after preoperative CRT revealed that the tumor disappeared, and pathological examination showed no malignant findings. Considering the risks of general anesthesia, the"watch and wait therapy"approach was adopted with sufficient informed consent. At present, 15 months after preoperative CRT, no evidence of regrowth or distant metastasis has been detected under rigorous follow- up evaluations.

• Authors: Yasuo Obata, Yoshifumi Shimada, Atsushi Ohta, Akio Matsumoto, Kana Tanaka, Hidehito Oyanagi, Mae Nakano, Masato Nakano, Hiroshi Ichikawa, Takaaki Hanyu, Kazuyasu Takizawa, Masayuki Nagahashi, Jun Sakata, Takashi Kobayashi, Toshifumi Wakai
• Journal: Gan to kagaku ryoho. Cancer & chemotherapy (Gan To Kagaku Ryoho) Vol. 47 Issue 13 Pg. 1960-1962 (Dec 2020) ISSN: 0385-0684 [Print] Japan
• PMID: 33468766 (Publication Type: Case Reports, Journal Article)

Topics

• Adenocarcinoma (complications, pathology, therapy)
• Aged
• Chemoradiotherapy
• Emphysema
• Humans
• Male
• Neoadjuvant Therapy
• Neoplasm Staging
• Rectal Neoplasms (complications, pathology, therapy)