| A Case of Curative Resection after Neoadjuvant Chemotherapy
in Locally Advanced, Unresectable Right Colon Cancer |
| Soon Do Park, Kil Yeon Lee, Sun Jin Park, Sang Mok Lee, Sung Wha Hong |
| Department of Surgery, Kyung Hee University School of Medicine, Seoul, Korea |
| 절제 불가능한 우측 결장암 환자에서 선행 항암화학요법 후 근치적 절제를 시행한 1예 |
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박순도, 이길연, 박선진, 이상목, 홍성화 |
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경희대학교 의과대학 외과학교실 |
| Corresponding Author:
Kil Yeon Lee ,Tel: +82-2-958-8261, Fax: +82-2-966-9366, Email: Isaac34@korea.com |
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Received: April 2, 2009; Accepted: April 28, 2009. |
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| ABSTRACT |
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Locally advanced colon cancer means T4 stage cancer directly invading adjacent organ regardless of distant metastasis. When
the cancer is resectable, multivisceral en bloc resection is recommended. Overall survival can be prolonged by multivisceral en
bloc resection in right colon cancer invading pancreas head or duodenum. We report a case of curative resection after
neoadjuvant chemotherapy in locally advanced, unresectable right colon cancer. 52-year-old female was diagnosed as cancer
in hepatic flexure of colon, which was involving pancreas head and 2nd portion of duodenum. Right hemicolectomy and pylorus
preserving pancreaticoduodectomy (PPPD) were planned at the 1st operation, but palliative ileocolostomy was constructed
because of massive peritumoral invasion and adhesion. After 5 cycles of XELOX chemotherapy regimen, patient’s CEA level
decreased to normal and CT scans showed smaller colonic tumor, and disappeared pancreatic and duodenal metastasis. So we
could do right hemicolectomy and lymph node dissection. 5 months later after adjuvant chemotherapy (12 cycles of FOLFIRI),
recurrent cancer was found in 2nd portion of duodenum, so we had to do PPPD. The patient still alives without cancer recurrence
for 19 months after the last operation. This case highlights the possibility of curative resection after neoadjuvant chemotherapy
in initially unresectable locally advanced right colon cancer. |
| Keywords:
Colonic neoplasms | Neoadjuvant chemotherapy |
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