[Show abstract][Hide abstract] ABSTRACT: A 52-year-old man who was diagnosed with esophagogastric junction cancer underwent left thoracolaparotomy and total gastrectomy. At 3 years and 11 months after the surgery, his carcinoembryonic antigen value was elevated, and cervical and right paraesophageal lymph node enlargement was detected by chest computed tomography(CT). Although lymph node dissection was performed, the presence of microscopic cancer-positive surgical stumps was confirmed. Since then, combination chemoradiotherapy using S-1 and radiation(60 Gy) has been applied. Currently, the patient is alive with no signs of lesion recurrence according to CT findings 8 years and 11 months after the initial surgery.
No preview · Article · Nov 2012 · Gan to kagaku ryoho. Cancer & chemotherapy
[Show abstract][Hide abstract] ABSTRACT: If hepatic or pulmonary metastases from colorectal cancer are resectable, we perform the operation, and the 5-year survival rate is 40-50%. Median survival time is over 20 months recently for systemic chemotherapy. However, surgical treatment is the only way to obtain a cure. RFA has the advantage of being minimally invasive. But the local recurrence rate is slightly high. It is important to detect a local recurrence early and perform repeated RFA. Repeated RFA improve the prognosis and get the same overall survival rate of liver resection. If both the hepatic and pulmonary metastases are resectable, we perform both resections, with a good surgical outcome. If we cannot perform a second metastasectomy after first metastasectomy, the prognosis is very poor compared to the prognosis for liver metastasis only or lung metastasis only. It is necessary to add many cases to decide the surgical indication for such cases of both liver and lung metastases.
No preview · Article · Feb 2011 · Gan to kagaku ryoho. Cancer & chemotherapy
[Show abstract][Hide abstract] ABSTRACT: The number of surgeries for colorectal cancer in elderly patients is increasing in correspondence to Japan's aging society. It is important to evaluate the patient's condition in order to carry out operations safely. The Onodera index (Onodera index in order (PNI: prognostic nutritional index)=serum alb value × 10+the lymphocyte counts of peripheral blood) is a simple and useful tool for choosing the method of operation. In our experience, 75% of elderly patients had pre-operative complications. Respiratory and circulatory complications occurred more frequently after operations. Pre- and post-operative adequate management can help facilitate a safer operation. Even if a curative operation was carried out for an elderly patient, both the cancer-specific survival rate and the 5-year relative survival rate were good. If the operation is tolerable for the elderly patient, curative resection should be performed. Chemotherapy in elderly should be also evaluated by the patient's activities of daily living and the regimen of chemotherapy should be selected.
No preview · Article · Dec 2010 · Gan to kagaku ryoho. Cancer & chemotherapy