Skip to main content
SpringerLink
Log in

A 55-year-old woman with locally advanced rectal cancer and a resectable synchronous hepatic metastasis: a case report

  • case report
  • Published:
memo - Magazine of European Medical Oncology Aims and scope Submit manuscript

Abstract

We describe the case of a 55-year-old woman initially diagnosed with locally advanced rectal cancer and one synchronous hepatic metastasis in 1998 who was treated by neoadjuvant chemotherapy and chemoradiotherapy followed by resection of the rectum and simultaneous atypical liver resection. After complete remission for about 4 years, the patient metachronously developed two local relapses and a liver metastasis, which were curatively treated by means of either radical resection or local ablative therapies and chemotherapy. Since the patient has refused radical resection of pulmonary metastases in November 2010, she is under palliative chemotherapy and is still alive. This case illustrates that a multimodality treatment can provide long-term survival in patients with metastasized colorectal cancer.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Abbreviations

Chemoradiotherapy:

CRT

Colorectal cancer:

CRC

Chemotherapy:

CTX

Total mesorectal excision:

TME

5-Fluorouracil:

5-FU

Leucovorin:

LV

Bevacizumab:

BV

Radiofrequency ablation:

RFA

Radiotherapy:

RTX

References

  1. Sauer R, Liersch T, Merkel S, Fietkau R, Hohenberger W, Hess C, et al. Preoperative versus postoperative chemoradiotherapy for locally advanced rectal cancer: results of the German CAO/ARO/AIO-94 randomized phase III trial after a median follow-up of 11 years. J Clin Oncol. 2012;30:1926–33.

    Article  PubMed  CAS  Google Scholar 

  2. Tsai MS, Su YH, Ho MC, Liang JT, Chen TP, Lai HS, et al. Clinicopathological features and prognosis in resectable synchronous and metachronous colorectal liver metastasis. Ann Surg Oncol. 2007;14:786–94.

    Article  PubMed  Google Scholar 

  3. Vigano L, Ferrero A, Lo Tesoriere R, Capussotti L. Liver surgery for colorectal metastases: results after 10 years of follow-up. Long-term survivors, late recurrences, and prognostic role of morbidity. Ann Surg Oncol. 2008;15:2458–64.

    Article  PubMed  Google Scholar 

  4. van Gijn W, Marijnen CA, Nagtegaal ID, Kranenbarg EM, Putter H, Wiggers T, et al. Preoperative radiotherapy combined with total mesorectal excision for resectable rectal cancer: 12-year follow-up of the multicentre, randomised controlled TME trial. Lancet Oncol. 2011;12:575–82.

    Article  PubMed  Google Scholar 

  5. Nordlinger B, Sorbye H, Glimelius B, Poston GJ, Schlag PM, Rougier P, et al. Perioperative chemotherapy with FOLFOX4 and surgery versus surgery alone for resectable liver metastases from colorectal cancer (EORTC Intergroup trial 40983): a randomised controlled trial. Lancet. 2008;371:1007–16.

    Article  PubMed  CAS  Google Scholar 

  6. Rodel C, Hofheinz R, Liersch T. Rectal cancer: state of the art in 2012. Curr Opin Oncol. 2012;24:441–7.

    Article  PubMed  Google Scholar 

  7. Calvo FA, Gomez-Espi M, Diaz-Gonzalez JA, Alvarado A, Cantalapiedra R, Marcos P, et al. Intraoperative presacral electron boost following preoperative chemoradiation in T3-4Nx rectal cancer: initial local effects and clinical outcome analysis. Radiother Oncol. 2002;62:201–6.

    Article  PubMed  Google Scholar 

  8. Krempien R, Roeder F, Oertel S, Weitz J, Hensley FW, Timke C, et al. Intraoperative electron-beam therapy for primary and recurrent retroperitoneal soft-tissue sarcoma. Int J Radiat Oncol Biol Phys. 2006;65:773–9.

    Article  PubMed  Google Scholar 

  9. Yu TK, Bhosale PR, Crane CH, Iyer RB, Skibber JM, Rodriguez-Bigas MA, et al. Patterns of locoregional recurrence after surgery and radiotherapy or chemoradiation for rectal cancer. Int J Radiat Oncol Biol Phys. 2008;71:1175–80.

    Article  PubMed  Google Scholar 

  10. Hoffman JP, Riley L, Carp NZ, Litwin S. Isolated locally recurrent rectal cancer: a review of incidence, presentation, and management. Semin Oncol. 1993;20:506–19.

    PubMed  CAS  Google Scholar 

  11. Ruers T, Punt C, Van Coevorden F, Pierie JP, Borel-Rinkes I, Ledermann JA, et al. Radiofrequency ablation combined with systemic treatment versus systemic treatment alone in patients with non-resectable colorectal liver metastases: a randomized EORTC Intergroup phase II study (EORTC 40004). Ann Oncol. 2012.

  12. Cirocchi R, Trastulli S, Boselli C, Montedori A, Cavaliere D, Parisi A, et al. Radiofrequency ablation in the treatment of liver metastases from colorectal cancer. Cochrane Database Syst Rev. 2012;6:CD006317.

    PubMed  Google Scholar 

  13. Adam R, Bhangui P, Poston G, Mirza D, Nuzzo G, Barroso E, et al. Is perioperative chemotherapy useful for solitary, metachronous, colorectal liver metastases? Ann Surg. 2010;252:774–87.

    Article  PubMed  Google Scholar 

  14. Parks R, Gonen M, Kemeny N, Jarnagin W, D’Angelica M, DeMatteo R, et al. Adjuvant chemotherapy improves survival after resection of hepatic colorectal metastases: analysis of data from two continents. J Am Coll Surg. 2007;204:753–61 (discussion 61–3).

    Article  PubMed  Google Scholar 

  15. Portier G, Elias D, Bouche O, Rougier P, Bosset JF, Saric J, et al. Multicenter randomized trial of adjuvant fluorouracil and folinic acid compared with surgery alone after resection of colorectal liver metastases: FFCD ACHBTH AURC 9002 trial. J Clin Oncol. 2006;24:4976–82.

    Article  PubMed  CAS  Google Scholar 

  16. Onaitis MW, Petersen RP, Haney JC, Saltz L, Park B, Flores R, et al. Prognostic factors for recurrence after pulmonary resection of colorectal cancer metastases. Ann Thorac Surg. 2009;87:1684–8.

    Article  PubMed  Google Scholar 

  17. Grothey A, Sugrue MM, Purdie DM, Dong W, Sargent D, Hedrick E, et al. Bevacizumab beyond first progression is associated with prolonged overall survival in metastatic colorectal cancer: results from a large observational cohort study (BRiTE). J Clin Oncol. 2008;26:5326–34.

    Article  PubMed  CAS  Google Scholar 

  18. Hong YS, Lee J, Kim KP, Lee JL, Park YS, Park JO, et al. Multicenter phase II study of second-line bevacizumab plus doublet combination chemotherapy in patients with metastatic colorectal cancer progressed after upfront bevacizumab plus doublet combination chemotherapy. Invest New Drugs. 2012.

  19. Arnold D, Thierry A, Bennouna J, Sastre J, Osterlund PJ, Greil R, et al. Bevacizumab (BEV) plus chemotherapy (CT) continued beyond first progression in patients with metastatic colorectal cancer (mCRC) previously treated with BEV plus CT: results of a randomized phase III intergroup study (TML study). J Clin Oncol. 2012;30(15 suppl):CRA3503 (May 20 Supplement).

    Google Scholar 

  20. Masi G, Loupakis F, Salvatore L, Cremolini C, Fornaro L, Schirripa M, et al. A randomized phase III study evaluating the continuation of bevacizumab (BV) beyond progression in metastatic colorectal cancer (mCRC) patients (pts) who received BV as part of first-line treatment: results of the BEBYP trial by the Gruppo Oncologico Nord, ESMO abstract 2012.

Download references

Conflict of interest

The authors declare that there is no actual or potential conflict of interest in relation to this article.

Author information

Authors and Affiliations

  1. 3rd Medical Department with Hematology, Medical Oncology, Hemostaseology, Rheumatology and Infectiology, Paracelsus Private Medical University of Salzburg, Müllner Hauptstrasse 48, 5020, Salzburg, Austria

    Florian Hohla MD,  Peter Mayer &  Richard Greil

  2. Department of Surgery, Paracelsus Private Medical University of Salzburg, Müllner Hauptstrasse 48, 5020, Salzburg, Austria

    Jörg Hutter MD

  3. Institute of Radiology, Paracelsus Private Medical University of Salzburg, Müllner Hauptstrasse 48, 5020, Salzburg, Austria

    Thomas Meißnitzer MD

Authors
  1. Florian Hohla MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Peter Mayer
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jörg Hutter MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Thomas Meißnitzer MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Richard Greil
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Florian Hohla MD.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Hohla, F., Mayer, P., Hutter, J. et al. A 55-year-old woman with locally advanced rectal cancer and a resectable synchronous hepatic metastasis: a case report. memo 5, 273–276 (2012). https://doi.org/10.1007/s12254-012-0060-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12254-012-0060-x

Keywords

Search

Navigation