肝臓, 卵巣, 大動脈周囲リンパ節の再発病巣を繰り返し切除し長期生存した大腸癌の1例 [in Japanese] A Long-term Survival Case of Colon Cancer with Resection of Recurrence in the Liver, Ovary, and Paraaortic Lymph Node [in Japanese]
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患者は46歳女性,平成13年1月に横行結腸癌に対し結腸右半切除を施行した.病理組織学的検査はmod,ss,ly1,v1,n2,stage IIIbであった.術後5-'DFURを内服していたが,同年7月に肝S4に転移を認め,肝部分切除およびリザーバー留置を施行.5-FU 500mg/週による肝動注を施行していたが,同年9月に左卵巣転移を認め左卵巣摘出術を施行した.術後は5-FU+LV療法(RPMIレジメン)を7クール施行後,UFT内服で外来通院していた.平成16年4月に大動脈周囲リンパ節転移を認め,CPT-11(A法)を施行したが改善せず,同年10月に大動脈周囲リンパ節郭清を施行した.術後はTS-1の内服を継続し,初回手術から6年1カ月経ったが再発なく外来通院中である.大腸癌転移巣に対しては,完全切除できる場合には積極的に切除することで長期生存が得られる可能性があり,患者の全身状態とQOLを考慮して試みる価値があると考える.
The patient was a 46-year-old woman. She had undergone right hemicolectomy for a transverse colon tumor in January 2001. Pathologically, the tumor was diagnosed as moderately differentiated adenocarcinoma, ss, ly1, v1 n2, stage IIIb. After the surgery, she took 5' DFUR. In April 2001, liver metastasis was identified in S4 and she underwent hepatic partial resection and infusing reserve plantation. After the surgery, she was injected with 5-FU 500mg/week. In October 2001, she was diagnosed as left ovarian metastasis, so she underwent ovarian resection. After the surgery, she was treated with 5-FU/1-LV for 7 courses, and after the courses, she took UFT. In April 2004, she was diagnosed as paraaortic lymph node recurrence and was treated for CPT-11, but the treatment was not effective. So she underwent paraaorta lymph node dissection, and took TS-1 after the surgery. For 4 years and 6 months after the first operation, there apparent recurrence was not found. If the metastasis of colon cancer is solitally, surgical resection is recommended.
- The Japanese journal of proctology
The Japanese journal of proctology 59(6), 328-332, 2006-06-01
The Japan Society of Coloproctology