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KMID : 1188520090050010027
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Korean Journal of Clinical Oncology
2009 Volume.5 No. 1 p.27 ~ p.30
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A Case of Curative Resection after Neoadjuvant Chemotherapy in Locally Advanced, Unresectable Right Colon Cancer
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Park Soon-Do
Lee Kil-Yeon
Park Sun-Jin
Hong Sung-Wha
Lee Sang-Mok
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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.
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KEYWORD
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Colonic neoplasms, Neoadjuvant chemotherapy
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