An Example of the Liver Metastases Downstaging Following Chemoport Implantation
Authors:
J. Kolařík; J. Drápela
Authors‘ workplace:
Chirurgické oddělení, Okresní nemocnice Havlíčkův Brod, primář: MUDr. J. Drápela
Published in:
Rozhl. Chir., 2008, roč. 87, č. 3, s. 145-148.
Category:
Monothematic special - Original
Overview
The case review describes a case of a patient, hospitalized with T3N0M1 carcinoma of the splenic flexure, with multiple metastases in the both liver lobes. The patient underwent left- sided hemicolectomy with cholecystectomy. Having considered the inoperable liver findings, a chemoport was implanted. The patient underwent 10 chemotherapy cycles with no major complications recorded. The chemotherapy cycle included Campto, Leucovorin, 5FU and, concomittantly, 5FU as a continual 22-hour infusion into the port. After completion of the Cycle 10, the ultrasound and CT findings showed marked regression of the metastases, by half to two thirds. Following consultation at the onco-surgical seminar, extended left-sided hemihepatectomy was performed. The procedure lasted 6 hours, the blood loss was 3.500 ml, the period of warm ischemia was 8 minutes. Based on the oncologists’ recommendation, the chemoport was preserved. The latest abdominal ultrasound detected no focal liver changes, a hypechogenic to unechogenic septed formation, v.s. a postoperative hematoma, was detected near the medial liver margin. Based on the conclusion of the oncological assessment, the patient was indicated for adjuvant chemotherapy, containg the same agents, for a period of 2–3 months. The aim of this report is to present a case of downstaging of the originally inoperable finding of the liver metastases.
Key words:
liver metastases – chemoport – downstaging – liver resection
Sources
1. Riesner, K.-P., Winkeltau, G., Kasperk, R., Cheby, L., Schumpelick, V. Adjuvante regionale arterielle Portchemoterapie nach Resektion colorectaler Lebermetastasen. Chirurg, 1998, r. 69, s. 741–746.
2. Suchý, T. Lokální chemoterapie u nemocných s jaterními malignímu. Bulletin HPB 1993, r. 1, č.l, abstrakt dostupný také na: http://www.hpb.cz/index.php?pld=93-l.
3. Petrowsky, H., Clavien, P.-A. Integriertes Handlungskonzept bei kolorektalen Lebermetastasen. Chirurgische Gastroenterologie, 2003, r. 19, s. 377–383, dostupný také na: http://content. karger. com/ProdukteDB/produkte. asp?Doi= 76075.
4. Folprecht G., von Ruthendorf, J. Kasuistik I: Resektion von Lebermetastasen nach Terapie mit Cetuximab und Irinotekan (5FU) Folinsäure. Journal onkologie 2005, Zeitschrift online- Ausgabe 03-05, dostupný na: http://www.journalonko. de/aktuellview.php ? id= 1213.
5. Folprecht G., Köhne C.-H. Neoadjuvante chemoterapie von kolorektalen Lebermetastasen. Journal onkologie 2005, Zeitschrift online- Ausgabe 03-05, dostupný na:
http://www.journalonko.de/aktuellview.php? id=l120.
6. Zavoral, M., Závada, F., Frič, P. Český národní program sekundární prevence kolorektálního karcinomu, Česká a slovenská gastroenterologie a hematologie, dostupný na: http://www.csgh.info/detail.php?stat=6.
7. Třeška, V., Skalický, T. Současné možnosti chirurgické léčby jaterních metastáz kolorektálního karcinomu, Bulletin HPB 2005, ročník 13, č. 2, dostupný na:
http://www. hpb. cz/index.php?pId=05-2-08.
8. Drápela, J., Brychta, M, Křikava, K., Abrahám, J., Zahálka, M., Kořínek, J. Jaterní metastázy kolorektálního karcinomu. Rozhl. Chir., 1997, č. 2, s. 72–75.
Labels
Surgery Orthopaedics Trauma surgeryArticle was published in
Perspectives in Surgery
2008 Issue 3
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