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簡介:
102
8
[1]
10-15
(en bloc
resection)
40-90
[2-4]
[5]
tumor downstaging
pathologic complete
response
30
[6]
病例報告:
67
(cT4aN2bM0 stage 3C)( )
FOLFOX
Eloxatin:85mg/m2
+5-FU:2800mg/
m2
/48hr 5
5000 6
FOLFOX 5
( )
- Uracil-Tegafur
22
討論:
R1
resection
[7]
en-block multivisceral
resection
7-60
[3,
8]
33
30
3 85.9
73.7 [9]
[10-11]
[12-13]
9
3 4
36
12
[9]
[3,
14]
Croner 174
2
[3] Mayo Clinic
9
5 49 12
[15]
:
1.
2. Lehnert T, Methner M, Pollok A, et al.
Multivisceral resection for locally advanced
primary colon and rectal cancer: an analysis of
prognostic factors in 201 patients. Ann Surg
2002;235:217–25.
3. Croner RS, Merkel S, Papadopoulos T, et al.
Multivisceral resection for colon carcinoma.
Dis Colon Rectum 2009;52:1381–6.
4. Gebhardt C, Meyer W, Ruckriegel S, Meier
U. Multivisceral resection of advanced
colorectal carcinoma. Langenbecks Arch Surg
1999;384:194–9.
5. NCCN guidelines, rectal cancer, version 2,
2016.
6. Huang CM, Huang MY, Tsai HL et al. An
observational study of extending FOLFOX
chemotherapy, lengthening the interval
between radiotherapy and surgery, and
enhancing pathological complete response
rates in rectal cancer patients following
preoperative chemoradiotherapy. Therap Adv
Gastroenterol 2016;9(5):702-12
7. Hermanek P, Wittekind C. Residual tumor (R)
1994;10:12–20.
8. Camma C, Giunta M, Fiorica F, et al.
Preoperative radiotherapy for resectable
rectal cancer: a meta-analysis. JAMA
2000;284:1008-15.
9. M Cukier, A.J. Smith, L. Milot et al.
Neoadjuvant chemoradiotherapy and
multivisceral resection for primary locally
advanced adherent colon cancer: A single
institution experience. Eur J Surg Oncol
2012;38(8):677-82
10.García-Aguilar J, Hernandez de Anda E,
Sirivongs P, et al. A pathologic complete
response to preoperative chemoradiation is
associated with lower local recurrence and
improved survival in rectal cancer patients
treated by mesorectal excision. Dis Colon
Rectum 2003;46:298-304.
11.Capirci C, Valentini V, Cionini L, et al.
Prognostic value of pathologic complete
response after neoadjuvant therapy in locally
advanced rectal cancer: long-term analysis of
566 ypCR patients. Int J Radiat Oncol Biol
Phys 2008;72:99-107.
12.Donington JS, Miller DL, Allen MS,
Deschamps C, Nichols FC, Pairolero PC.
Tumor response to induction chemoradiation:
J Cardiothorac Surg. 2003;24(4):631-6.
13.Meredith KL, Weber JM, Turaga KK, et al.
Pathologic response after neoadjuvant therapy
is the major determinant of survival in patients
with esophageal cancer. Ann Surg Oncol.
2010;17(4): 1159-67
14.Park S, Lee YS. Analysis of the prognostic
effectiveness of a multivisceral resection for
locally advanced colorectal cancer. J Korean
Soc Coloproctol 2011;27:21-6.
15.Taylor WE, Donohue JH, Gunderson LL,
et al. The Mayo clinic experience with
multimodality treatment of locally advanced
or recurrent colon cancer. Ann Surg Oncol
2002;9:177–85.

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高雄醫師會誌93期-病例討論~黃鈞民、王照元-術前同步化學放射治療合併手術切除成功治療局部進行期結腸癌

  • 2. tumor downstaging pathologic complete response 30 [6] 病例報告: 67 (cT4aN2bM0 stage 3C)( ) FOLFOX Eloxatin:85mg/m2 +5-FU:2800mg/ m2 /48hr 5 5000 6 FOLFOX 5 ( ) - Uracil-Tegafur 22
  • 3. 討論: R1 resection [7] en-block multivisceral resection 7-60 [3, 8] 33 30 3 85.9 73.7 [9] [10-11] [12-13] 9 3 4 36 12 [9] [3, 14] Croner 174 2 [3] Mayo Clinic 9 5 49 12 [15]
  • 4. : 1. 2. Lehnert T, Methner M, Pollok A, et al. Multivisceral resection for locally advanced primary colon and rectal cancer: an analysis of prognostic factors in 201 patients. Ann Surg 2002;235:217–25. 3. Croner RS, Merkel S, Papadopoulos T, et al. Multivisceral resection for colon carcinoma. Dis Colon Rectum 2009;52:1381–6. 4. Gebhardt C, Meyer W, Ruckriegel S, Meier U. Multivisceral resection of advanced colorectal carcinoma. Langenbecks Arch Surg 1999;384:194–9. 5. NCCN guidelines, rectal cancer, version 2, 2016. 6. Huang CM, Huang MY, Tsai HL et al. An observational study of extending FOLFOX chemotherapy, lengthening the interval between radiotherapy and surgery, and enhancing pathological complete response rates in rectal cancer patients following preoperative chemoradiotherapy. Therap Adv Gastroenterol 2016;9(5):702-12 7. Hermanek P, Wittekind C. Residual tumor (R) 1994;10:12–20. 8. Camma C, Giunta M, Fiorica F, et al. Preoperative radiotherapy for resectable rectal cancer: a meta-analysis. JAMA 2000;284:1008-15. 9. M Cukier, A.J. Smith, L. Milot et al. Neoadjuvant chemoradiotherapy and multivisceral resection for primary locally advanced adherent colon cancer: A single institution experience. Eur J Surg Oncol 2012;38(8):677-82 10.García-Aguilar J, Hernandez de Anda E, Sirivongs P, et al. A pathologic complete response to preoperative chemoradiation is associated with lower local recurrence and improved survival in rectal cancer patients treated by mesorectal excision. Dis Colon Rectum 2003;46:298-304. 11.Capirci C, Valentini V, Cionini L, et al. Prognostic value of pathologic complete response after neoadjuvant therapy in locally advanced rectal cancer: long-term analysis of 566 ypCR patients. Int J Radiat Oncol Biol Phys 2008;72:99-107. 12.Donington JS, Miller DL, Allen MS, Deschamps C, Nichols FC, Pairolero PC. Tumor response to induction chemoradiation: J Cardiothorac Surg. 2003;24(4):631-6. 13.Meredith KL, Weber JM, Turaga KK, et al. Pathologic response after neoadjuvant therapy is the major determinant of survival in patients with esophageal cancer. Ann Surg Oncol. 2010;17(4): 1159-67 14.Park S, Lee YS. Analysis of the prognostic effectiveness of a multivisceral resection for locally advanced colorectal cancer. J Korean Soc Coloproctol 2011;27:21-6. 15.Taylor WE, Donohue JH, Gunderson LL, et al. The Mayo clinic experience with multimodality treatment of locally advanced or recurrent colon cancer. Ann Surg Oncol 2002;9:177–85.