Successful Combined Treatment of a Patient with Borderline Resectable Liver Metastasis of Colorectal Cancer
https://doi.org/10.22416/1382-4376-2022-32-6-65-71
Abstract
Aim: to present the value of interventional radiology techniques in the treatment of a patient with liver metastasis of colorectal cancer.
Key points. In 2013, a 60-year-old patient with stage IIIB sigmoid colon cancer, pT3N2M0 underwent resection of the sigmoid colon with the formation of hardware rectosigmoanastomosis, 6 courses of adjuvant chemotherapy were performed. In 2015, a control examination revealed metastatic liver damage. Liver resection could not be performed due to the small future residual volume, and systemic chemotherapy was not effective. The patient underwent 3 cycles of regional chemotherapy. Taking into account the pronounced positive dynamics, in the form of a decrease in tumor size and a decrease in cancer markers, the patient managed to perform an extended right-sided hemihepatectomy. No progression of the tumor process was detected during the follow-up.
Conclusion. Modern possibilities of X-ray endovascular methods allow to achieve results in the treatment of patients with colorectal cancer metastases in the liver such as a decrease in metastases in size, that make liver resection possible.
About the Authors
O. Yu. Stukalova
Central Clinical Hospital “RZhD-Medicine”
Russian Federation
Russian Federation
Oksana Yu. Stukalova — coloproctologist, Coloproctology (oncology) department, Central Clinical Hospital “RZhD-Medicine”.
129128, Moscow, Budayskaya str., 2
A. A. Polikarpov
Russian Scientific Center of Radiology and Surgical Technologies named after Academician A.M. Granov
Russian Federation
Russian Federation
Alexey A. Polikarpov — Dr. Sci. (Med.), Prof. of the Department of Radiology, Surgery and Oncology, Doctor of the Department of Angiography of the Russian Scientific Center of Radiology and Surgical Technologies named after academician A.M. Granov.
197758, St. Petersburg, Pesochny settlement, Leningradskaya str., 70
A. V. Moiseenko
Russian Scientific Center of Radiology and Surgical Technologies named after Academician A.M. Granov
Russian Federation
Russian Federation
Andrey V. Moiseenko — doctor, Department of abdominal oncology and X-ray surgical methods of diagnostics and treatment of the Russian Scientific Center of Radiology and Surgical Technologies named after Academician A.M. Granov.
197758, St. Petersburg, Pesochny settlement, Leningradskaya str., 70
D. A. Granov
Russian Scientific Center of Radiology and Surgical Technologies named after Academician A.M. Granov; First St. Petersburg State Medical University named after Academician I.P. Pavlov
Russian Federation
Russian Federation
Dmitry A. Granov — Dr. Sci. (Med.), Prof., Academician of the Russian Academy of Sciences, Scientific Director of the Russian Scientific Center of Radiology and Surgical Technologies named after academician A.M. Granov; Head of the Department of Radiology and Surgical Technologies of the First St. Petersburg State Medical University.
197758, St. Petersburg, Pesochny settlement, Leningradskaya str., 70; 197022, St. Petersburg, Lva Tolstogo str., 6-8
References
1. Kaprin A.D., Starinsky V.V., Shakhzadova A.O. (ed.) Malignant neoplasms in Russia in 2020 (morbidity and mortality). Moscow: MNIOI im. P.A. Herzen — a branch of the NMITs Radiology, 2021 (In Russ.).
2. Cancer Research UK. Bowel Cancer Statistics. 2015—2017 [(accessed on 30 June 2020)]. URL: https://www.cancer-researchuk.org/health-profession.
3. Ionkin D.A., Zhavoronkova O.I., Stepanova Yu.A., Gavrilov Ya.Ya., Chzhao A.V. Thermal methods of local destruction (RFA, cryodestruction, microwave ablation) in metastatic liver cancer. Aspirantskiy Vestnik Povolzhiya. 2018;5—6:127—45 (In Russ.). DOI: 10.17816/2072-2354.2018.18.3.127-145
4. Zagainov A.S., Shelekhov A.V., Dvornichenko V.V., Rasulov R.I., Zubkov R.A. Treatment outcomes of colorectal cancer with bilateral liver metastases. Siberian Journal of Oncology. 2017;16(1):66—70 ) In Russ.)].
5. Seregin A.A. X-ray endovascular chemoembolization of the hepatic artery — a modern method of regional chemotherapy of malignant liver lesions (review). Modern technologies in medicine. 2014;2:110-26 (In Russ.).
6. Nordlinger B., Sorbye H., Glimelius B., et al; EO-RTC Gastro-Intestinal Tract Cancer Group; Cancer Research UK; Arbeitsgruppe Lebermetastasen und-tumoren in der Chirurgischen Arbeitsgemeinschaft Onkologie (ALM-CAO); Australasian Gastro-Intestinal Trials Group (AGITG); Federation Francophone de Cancerologie Digestive (FFCD). Perioperative FOLFOX4 chemotherapy and surgery versus surgery alone for resectable liver metastases from colorectal cancer (EORTC 40983): long-term results of a randomised, controlled, phase 3 trial. Lancet Oncol. 2013;14(12):1208-15. DOI: 10.1016/S1470-2045(13)70447-9
7. Popov M.V., Aronov M.S., Voskanyan S.E., Karpova O.V. Transarterial chemoembolization for primary and metastatic liver tumors (revew). Saratov Journal of Medical Scientific Research. 2016;12(4):716—20 (In Russ.).
8. Rashidian N., Alseidi A., Kirks R.C. Cancers Metastatic to the Liver. Surg Clin North Am. 2020;100(3):551—63. DOI: 10.1016/j.suc.2020.02.005
9. Kulikovsky V.F., Oleinik N.V., Soloshenko A.V., Storozhilov D.A., Nikolaev S.B., Naumov A.V. Results of surgical treatment of patients with metastases of colorectal cancer in the liver. Koloproktologia. 2016;(1S):65-6 (In Russ.).
10. Frankel T.L., D'Angelica M.I. Hepatic resection for colorectal metastases. J Surg Oncol. 2014;109(1):2-7. DOI: 10.1002/jso.23371
11. Datta J., Narayan R.R., Kemeny N.E., D'Angelica M.I. Role of Hepatic Artery Infusion Chemotherapy in Treatment of Initially Unresectable Colorectal Liver Metastases: A Review. JAMA Surg. 2019;154(8):768-76. DOI: 10.1001/jamasurg.2019.1694. PMID: 31188415
12. Folprecht G., Gruenberger T., Bechstein W., Raab H.R., Weitz J., Lordick F., et al. Survival of patients with initially unresectable colorectal liver metastases treated with FOLFOX/cetuximab or FOLFIRI/cetuximab in a multidisciplinary concept (CELIM study). Ann Oncol. 2014;25(5):1018-25. DOI: 10.1093/annonc/mdu088
13. Takahashi H., Berber E. Role of thermal ablation in the management of colorectal liver metastasis. Hepatobil Surg Nutr. 2020;9(1):49-58. DOI: 10.21037/hbsn.2019.06.08
14. Malignant neoplasm of the colon. Clinical recommendations. 2022. URL: https://oncology-association.ru/clinical-guidelines
15. Adenis A., de la Fouchardiere C., Paule B., Burtin P., Tougeron D., Wallet J., et al. Survival, safety, and prognostic factors for outcome with Regorafenib in patients with metastatic colorectal cancer refractory to standard therapies: results from a multicenter study (REBECCA) nested within a compassionate use program. BMC Cancer. 2016;16(7):412-20. DOI: 10.1186/s12885-016-2440-9
16. Ychou M., Viret F., Kramar A., Desseigne F., Mitry E., Guimbaud R., et al. Tritherapy with fluorouracil/ leucovorin, irinotecan and oxaliplatin (FOLFIRINOX): a phase II study in colorectal cancer patients with non-resectable liver metastases. Cancer Chemother. Pharmacol. 2008;62(2):195-201.
17. Masi G., Loupakis F., Pollina L., Vasile E., Cupini S., Ricci S., et al. Long-term outcome of initially unresectable metastatic colorectal cancer patients treated with 5-fluorouracil/leucovorin, oxaliplatin, and irinotecan (FOLFOXIRI) followed by radical surgery of metastases. Ann Surg. 2009;249(3):420-5. DOI: 10.1097/SLA.0b013e31819a0486
18. Uetake H., Yasuno M., Ishiguro M., Mizunuma N., Komori T., Miyata G. et al. A multicenter phase II trial of mFOLFOX6 plus bevacizumab to treat liver-only metastases of colorectal cancer that are unsuitable for upfront resection (TRICC0808). Ann Surg Oncol. 2015;22(3):908-15. DOI: 10.1245/s10434-014-4094-7
19. Wong R., Cunningham D., Barbachano Y., Saffery C., Valle J., Hickish T., et al. A multicentre study of capecitabine, oxaliplatin plus bevacizumab as perioperative treatment of patients with poor-risk colorectal liver-only metastases not selected for upfront resection. Ann Oncol. 2011;22(9):2042-8. DOI: 10.1093/annonc/mdq714
20. Peeters M., Price T.J., Cervantes A., Sobrero A.F., Ducreux M., Hotko Y., et al. Final results from a randomized phase 3 study of FOLFIRI ± panitumumab for second-line treatment of metastatic colorectal cancer. Ann Oncol. 2014;25(1):107-16. DOI: 10.1093/annonc/mdt523
21. Jin B., Wu X., Xu G., Xing J., Wang Y., Yang H., et al. Evolutions of the Management of Colorectal Cancer Liver Metastasis: A Bibliometric Analysis. J Cancer. 2021;12(12):3660-70. DOI: 10.7150/jca.52842
22. Gruber-Rouh T., Naguib N.N., Eichler K., Ackermann H., Zangos S., Trojan J., et al. Transarterial chemoembolization of unresectable systemic chemotherapy-refractory liver metastases from colorectal cancer: Long-term results over a 10-year period. Int. J. Cancer. 2014;134:1225-31. DOI: 10.1002/ijc.28443
23. Ishchenko R.V., Dzhansyz I.N., Fesak I.V. Surgical technique of hepatic artery catheterization with selective intra-arterial chemotherapy. Malignant tumors. 2016;3(19):56-62 (In Russ.). DOI: 10.18027/2224-5057-2016-2-56-62.23
24. Miller A.B., Hoogstraten B., Staquet M., Winkler A. Reporting results of cancer treatment. Cancer. 1981;47(1):207-14. DOI: 10.1002/1097-0142(19810101)47:1<207::aid-cn-cr2820470134>3.0.co;2-6
25. Siegel R., Naishadham D., Jemal A. Cancer statistics, 2012. CA Cancer J Clin. 2012;62(1):10-29. DOI: 10.3322/caac.20138
26. Ishchenko R.V. Selective intra-arterial chemotherapy for liver metastases of colorectal cancer. Bulletin of Emergency and Reconstructive Surgery. 2016;1(1):43-7 (In Russ.).
27. Tanaka K., Shimada H., Kubota K., Ueda M., Endo I., Sekido H., Togo S. Effectiveness of prehepatectomy intra-arterial chemotherapy for multiple bilobar colorectal cancer metastases to the liver: a clinicopathologic study of peritumoral vasculobiliary invasion. Surgery. 2005;137(2):156-64. DOI: 10.1016/j.surg.2004.07.007
28. Polikarpov A.A., Tarazov P.G., Kagacheva T.I., Borovik V.V., Kozlov A.V., Granov D.A. Intraarterial chemotherapy in treatment of unresectable colorectal liver metastases refractory to systemic chemotherapy. Annals of HPB surgery. 2019;24(4):37-44 (In Russ.). DOI: 10.16931/1995-5464.2019437-44
29. Tarazov P.G., Granov D.A., Polikarpov A.A., Sergeev V.I., Kozlov A.V., Polekhin А-S., et al. Role of preoperative x-ray endovascular interventions for improvement of resectability of colorectal liver metastases. Grekov's Bulletin of Surgery. 2018;177(5):36-41 (In Russ.). DOI: 10.24884/0042-4625-2018-177-5-36-41
30. Miyanari N., Mori T., Takahashi K., Yasuno M. Evaluation of aggressively treated patients with unresectable multiple liver metastases from colorectal cancer. Dis Colon Rectum. 2002 Nov;45(11):1503-9. DOI: 10.1007/s10350-004-6458-8
Review
For citations:
Stukalova O.Yu., Polikarpov A.A., Moiseenko A.V., Granov D.A. Successful Combined Treatment of a Patient with Borderline Resectable Liver Metastasis of Colorectal Cancer. Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2022;32(6):65-71. https://doi.org/10.22416/1382-4376-2022-32-6-65-71
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