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- Title
Rectal cancer with multiple metastases achieving complete remission – case presentation.
- Authors
Seliuc, Claudia Paraschiva; Mateianu, Elena Adriana; Dragomir, Adelina Silvana; Radu, Andreea Mihaela; Komporaly, Isabela Anda; Mihăilă, Raluca Ioana; Georgescu, Bogdan; Kajanto, Lidia Anca; Stănculeanu, Dana Lucia
- Abstract
Colorectal cancer (CRC) is nowadays one of the three most common cancers all over the world, with high rates of mortality and morbidity not only in Western countries, but also in Romania. Even though the screening methods are widely available, more than 30% of patients have already distant organs or lymph node metastases when they are first diagnosed with colorectal cancer. We discuss the particularities of a stage IV rectal cancer case in a 62yearold female patient. In the context of emergency surgery for stenotic rectal carcinoma, a Hartmann’s procedure was successfully performed, the tumor mass was pathologically confirmed to be a colorectal adenocarcinoma, moderately differentiated, and molecular biology detected no RAS mutations. Moreover, the histopathological exam revealed multiple peritoneal lymph node metastases, whereas the PET scan highlighted three different hepatic lesions which were metabolically active. Weighing the stage of the carcinoma, the molecular analysis and the performance status of the patient, multiple series with FOLFIRI chemotherapy in combination with weekly cetuximab were performed. After three years of treatment, the CT scans showed a partial remission of the disease, which was eventually followed by complete remission. The diseasefree interval of one year was followed by the appearance of two new liver lesions for which new series with FOLFOX4 and biweekly cetuximab were initiated. An adverse reaction of cetuximab developed by the patient after several months required a new approach of the case: introducing bevacizumab, along with the FOLFOX regimen. The patient is currently under this treatment. In recent years, the prognosis of CRC has been improving. Several treatment strategies are potential keys for improving the prognosis of patients with CRC. These include closer followup after resection and earlier detection of metastatic disease, improvement in chemotherapeutic regimens, and the enhancement of meetings held by multidisciplinary teams and tumor boards.
- Subjects
ROMANIA; SURGICAL emergencies; METASTASIS; COLORECTAL cancer; RECTAL cancer; COMPUTED tomography; PROGNOSIS; LYMPHATIC metastasis
- Publication
Oncolog-Hematolog, 2021, Issue 55, p46
- ISSN
2066-8716
- Publication type
Article