[Successful treatment of a patient using mFOLFOX6 after laparoscopic surgery for rectal cancer with peritoneal dissemination].

Abstract

A 58-year-old man underwent laparoscopic surgery for rectal cancer(rectal sigmoid)complicated by intestinal obstruction. He had no liver metastasis. Although many nodules suspected to have arisen from peritoneal dissemination were observed in the pelvic cavity, we performed anterior resection assuming that the primary lesion was resectable. The surgical findings were sSE, sN2, sP3, sStage IV, and histopathological findings were signet-ring cell carcinoma, pSE, pN2, pP+, pStage IV. After 8 courses of adjuvant chemotherapy with modified 5-fluorouracil/Leucovorin/oxaliplatin(mFOLFOX6), carcinoembryonic antigen( CEA)decreased to a normal level, and positron emission tomography-computed tomography(PET-CT)showed no abnormal accumulation that suggested metastasis. To evaluate the effectiveness of this procedure, laparoscopic peritoneal biopsy was performed 5 months after surgery, revealing histopathological disappearance of the peritoneal dissemination lesion. The patient has been followed up and has been receiving S-1 for 1 year after the first surgery. No evidence of recurrence has been observed.

• Authors: Genya Hamano, Takashi Ikebe, Katsuyuki Mayumi, Masashi Takemura, Takaaki Hori, Takayoshi Nishioka
• Journal: Gan to kagaku ryoho. Cancer & chemotherapy (Gan To Kagaku Ryoho) Vol. 40 Issue 7 Pg. 951-4 (Jul 2013) ISSN: 0385-0684 [Print] Japan
• PMID: 23863744 (Publication Type: Case Reports, English Abstract, Journal Article)

Chemical References

• Organoplatinum Compounds
• Leucovorin
• Fluorouracil

Topics

• Antineoplastic Combined Chemotherapy Protocols (administration & dosage, therapeutic use)
• Combined Modality Therapy
• Fluorouracil (administration & dosage)
• Humans
• Laparoscopy
• Leucovorin (administration & dosage)
• Male
• Middle Aged
• Organoplatinum Compounds (administration & dosage)
• Peritoneal Neoplasms (drug therapy, secondary)
• Rectal Neoplasms (drug therapy, pathology, surgery)
• Tomography, X-Ray Computed