A case of advanced rectal cancer with multiple liver metastases successfully treated by perioperative administration of UFT and oral leucovorin

• Published in: Gan to kagaku ryoho Vol. 37; no. 9; p. 1817
• Main Authors: Kumazawa, Sachiko, Murata, Yujiro, Ishita, Takeshi, Nakamura, Satoshi, Tamura, Noriyasu, Oikawa, Yoshinori, Kubo, Yoshiko, Kurata, Nagayuki, Yagi, Kouichi, Hattori, Shoichi, Bando, Michiya, Mori, Masaki, Matsumoto, Kenji, Sato, Yuji, Machinami, Rikuo
• Format: Journal Article
• Language: Japanese
• Published: Japan 01-09-2010
• Subjects: Administration, Oral; Aged; Antineoplastic Combined Chemotherapy Protocols - administration & dosage; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Combined Modality Therapy; Hepatectomy; Humans; Leucovorin - administration & dosage; Leucovorin - therapeutic use; Liver Neoplasms - diagnostic imaging; Liver Neoplasms - drug therapy; Liver Neoplasms - secondary; Liver Neoplasms - surgery; Male; Neoplasm Staging; Rectal Neoplasms - diagnostic imaging; Rectal Neoplasms - drug therapy; Rectal Neoplasms - pathology; Rectal Neoplasms - surgery; Tegafur - administration & dosage; Tegafur - therapeutic use; Tomography, X-Ray Computed; Uracil - administration & dosage; Uracil - therapeutic use
• ISSN: 0385-0684

The patient was a sixty-five-year-old man who had an advanced rectal cancer (Ra, type 2) with liver metastases. Low anterior resection with lymphnode dissection (D3) was done, but hepatectomy was not performed because of the multiple metastases besides the five tumors detected preoperatively. The pathological finding was moderately-differentiated adenocarcinoma. He was treated with 5-FU via the hepatic artery, but the therapy failed due to catheter infection after 3 postoperative months. Then, he received general 5-FU/l-LV therapy intravenously from 3 to 8 months after the operation, and oral UFT/LV (Uzel®) from 9 to 22 months. Next, we switched to single UFT therapy at 23 months because CT findings showed remarkable calcification in the liver metastases. But only one tumor of the liver (S6) among liver metastases enlarged at 27 months. We switched the chemotherapy again to UFT/Uzel and mFOLFOX6, but decided to perform hepatectomy of S6/7 at 39 months since it proved ineffective. The pathological finding was 90% necrosis and calcification of the tumor. Metastasis of the right 10th rib was newly found and was removed at 63 months after the first operation. Now, NC in the liver is continued 67 months after the first operation, and the patient is doing well.