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An 11-year survivor who underwent ten sequential resections of colonic adenocarcinoma metastases
Authors:Nagakura Shigenori  Shirai Yoshio  Wakai Toshifumi  Nomura Tatsuya  Hatakeyama Katsuyoshi
Affiliation:Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Niigata City, 951-8510 Japan.
Abstract:Hepatectomy is an established treatment for colorectal carcinoma liver metastases. However, the benefit of multiple repeat metastasectomies in the management of colorectal carcinoma patients remains uncertain. We report the case of a 47-year-old man who underwent ten sequential resections of intra- and extrahepatic colonic adenocarcinoma metastases. Metastasectomy procedures in this case included: 6 hepatic resections, 2 pulmonary resections, 1 pulmonary resection combined with wide resection of the abdominal wall, and 1 wide resection of the abdominal wall. The patient finally died, from unresectable metastases to the liver and pancreas, 133 months after the initial hepatectomy. The aggressive multiple repeat metastasectomies may have provided this unusual long-term palliation. Colorectal carcinoma patients with sequential resectable recurrences may be candidates for multiple repeat metastasectomies. Surgeons should pursue resection for colorectal carcinoma metastases, regardless of frequent operations and sites involved, as reliable medical treatment remains unestablished.
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