[Show abstract][Hide abstract] ABSTRACT: A 62-year-old woman visited our hospital because of the increasing lower left abdominal distention. Computed tomography (CT) revealed pancreatic carcinoma invading to spleen with liver metastasis and peritoneal dissemination. Soon after, the patient showed a severe bowel obstruction symptom, so we performed an emergency operation. The pancreatic carcinoma was located at the tail of pancreas invading to spleen with liver metastasis. Due to peritoneal dissemination, severe stenosis and dilatation of the small intestine, stenosis of the ascending and sigmoid colon was admitted. We performed a distal pancreatectomy, partial hepatectomy, partial resection of the stomach, five-partial resection of the small intestine, right colectomy and sigmoidectomy. No operative complication was seen, and we started chemotherapy using gemcitabine soon after the operation. After 3 months, the tumor markers normalized. She was able to finish intestinal nutrition 8 months after the operation. At present (20 months after the operation), the patient is still alive with good performance status (PS 0). The removal of bowel obstruction by operation enabled us to perform intestinal nutrition and sufficient chemotherapy, which may lead to the favorable prognosis.
No preview · Article · Nov 2009 · Gan to kagaku ryoho. Cancer & chemotherapy
[Show abstract][Hide abstract] ABSTRACT: A 53-year-old man, admitted for inguinal hernia, complained of body weight loss in a preoperative condition check. We examined the digestive tract and diagnosed stage IV advanced rectal carcinoma with multiple lung metastases. It caused ileus, so emergency colostomy was performed. After that his general condition recovered, and two cycles of neoadjuvant chemotherapy (NAC) by irinotecan combined with 5-fluorouracil and l-leucovorin (IFL) therapy were performed on an outpatient basis. Lung metastatic nodules disappeared. We established a diagnosis of down staging for stage IIIa, and performed a lower anterior resection with D 2 lymph node dissection to allow a curability-A resection. The pathological effect of NAC was Grade 2. Post-operatively, two cycles of IFL therapy were then performed. There has been no sign of recurrence, and no adverse effects by chemotherapy have been seen during this treatment. Thus, NAC by IFL therapy can be one of the useful treatment approaches for patients with advanced rectal cancer.
No preview · Article · Dec 2006 · Gan to kagaku ryoho. Cancer & chemotherapy