MDT discussion of a case of recurrent metastatic colon cancer_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

ZHANG Xiaoli ^1,2 , WU Zhizhong ^1,3 , ZENG Liang ^1,2 , SHI Chengmin ^1,3 ,  LUO Huayou ^1,2,3 , ZENG Yujian ^1,2,3

1. Department of Gastrointestinal and Hernia Surgery, The First Affiliated Hospital of Kunming Medical University, Kunming 650032, P. R. China;
2. The National Health Council Key Laboratory of Drug Addiction Medicine, The First Affiliated Hospital of Kunming Medical University, Kunming650032, P. R. China;
3. Yunnan Institute of Digestive Disease, The First Affiliated Hospital of Kunming Medical University, Kunming 650032, P. R. China;

Corresponding author：

LUO Huayou, Email: km-lhy@qq.com

Keywords：

colon cancer; liver and lung metastasis; retroperitoneal metastasis; MDT; surgery

DOI：

10.7507/1007-9424.201910012

Video：

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Objective To summarize the experience of diagnosis and treatment of a patient with liver and lung metastasis and retroperitoneal metastasis from right colon cancer.Methods A retrospective analysis of a patient with liver, lung, and retroperitoneal metastasis from right colon cancer who received treatment at The First Affiliated Hospital of Kunming Medical University in August 2016 was conducted. In order to provide reference for domestic doctors to treat advanced colorectal cancer.Results After receiving several cycles of chemotherapy and three surgical resections of the primary and metastatic lesions before the MDT, the patient again found a retroperitoneal mass. After discussions of Department of Imaging, Oncology, Radiotherapy, and Gastrointestinal and Hernia Surgery, we thought that, at present, the treatment of the patient was mainly surgery and oral chemotherapy. So the patient underwent retroperitoneal tumor resection+abdominal adhesion release, and had been interviewed for 3 months. No recurrence or metastasis was found during follow-up.Conclusion The therapy of liver-lung metastasis and retroperitoneal metastasis in right colon cancer are mainly based on surgical resection of lesions, postoperative combined with radiotherapy and chemotherapy, molecular targeted therapy, and postoperative monitoring of CEA changes.

Citation： ZHANG Xiaoli, WU Zhizhong, ZENG Liang, SHI Chengmin, LUO Huayou, ZENG Yujian. MDT discussion of a case of recurrent metastatic colon cancer. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2020, 27(4): 476-482. doi: 10.7507/1007-9424.201910012 Copy

1.	张木根, 刘旭超, 连飞, 等. 经导管肝动脉化疗栓塞术联合射频消融在结肠癌肝转移患者中的应用. 华南国防医学杂志, 2019, 33(9): 649-651.
2.	闫晓菲, 李记彬, 李文雅, 等. 结肠癌伴可切除肝肺转移术前新辅助化疗一例. 中华结直肠疾病电子杂志, 2019, 8(1): 91-93.
3.	Salah S, Ardissone F, Gonzalez M, et al. Pulmonary metastasectomy in colorectal cancer patients with previously resected liver metastasis: pooled analysis. Ann Surg Oncol, 2015, 22(6): 1844-1850.
4.	Hattori N, Kanemitsu Y, Komori K, et al. Outcomes after hepatic and pulmonary metastasectomies compared with pulmonary metastasectomy alone in patients with colorectal cancer metastasis to liver and lungs. World J Surg, 2013, 37(6): 1315-1321.
5.	Chow FC, Chok KS. Colorectal liver metastases: an update on multidisciplinary approach. World J Hepatol, 2019, 11(2): 150-172.
6.	Pulitanò C, Bodingbauer M, Aldrighetti L, et al. Liver resection for colorectal metastases in presence of extrahepatic disease: results from an international multi-institutional analysis. Ann Surg Oncol, 2011, 18(5): 1380-1388.
7.	Akbarzadeh Khiavi M, Safary A, Somi MH. Recent advances in targeted therapy of colorectal cancer: impacts of monoclonal antibodies nanoconjugates. Bioimpacts, 2019, 9(3): 123-127.
8.	Tsukamoto S, Kinugasa Y, Yamaguchi T, et al. Survival after resection of liver and lung colorectal metastases in the era of modern multidisciplinary therapy. Int J Colorectal Dis, 2014, 29(1): 81-87.
9.	Gonzalez M, Robert JH, Halkic N, et al. Survival after lung metastasectomy in colorectal cancer patients with previously resected liver metastases. World J Surg, 2012, 36(2): 386-391.
10.	Wang Z, Wang X, Yuan J, et al. Survival benefit of palliative local treatments and efficacy of different pharmacotherapies in colorectal cancer with lung metastasis: results from a large retrospective study. Clin Colorectal Cancer, 2018, 17(2): e233-e255.
11.	Margalit O, Shacham-Shmueli E, Lawrence YR, et al. Lung metastasis predicts better prognosis in metastatic colorectal cancer with mutated KRAS. Clin Colorectal Cancer, 2019, 18(3): e300-e307.
12.	Song H, Zhong LP, He J, et al. Application of Newcastle disease virus in the treatment of colorectal cancer. World J Clin Cases, 2019, 7(16): 2143-2154.
13.	Reijonen P, Kivelä A, Rantonen J, et al. Long-term outcome after sequential liver and lung metastasectomy is comparable to outcome of isolated liver or lung metastasectomy in colorectal carcinoma. Surg Oncol, 2019, 30: 22-26.
14.	Zizzo M, Galeone C, Braglia L, et al. Long-term outcomes after surgical resection for synchronous or metachronous hepatic and pulmonary colorectal cancer metastases. Digestion, 2019, [Epub ahead of print].
15.	Sparchez Z, Mocan T, Hajjar NA, et al. Percutaneous ultrasound guided radiofrequency and microwave ablation in the treatment of hepatic metastases. A monocentric initial experience. Med Ultrason, 2019, 21(3): 217-224.
16.	Shibutani M, Nagahara H, Fukuoka T, et al. Efficacy of adjuvant chemotherapy according to the classification of recurrence risk based on systemic inflammatory markers in patients with liver metastases of colorectal cancer. Anticancer Res, 2019, 39(9): 5039-5045.
17.	Leung U, Gönen M, Allen PJ, et al. Colorectal cancer liver metastases and concurrent extrahepatic disease treated with resection. Ann Surg, 2017, 265(1): 158-165.
18.	Li J, Yuan Y, Yang F, et al. Expert consensus on multidisciplinary therapy of colorectal cancer with lung metastases (2019 edition). J Hematol Oncol, 2019, 12(1): 16.
19.	Engstrand J, Nilsson H, Strömberg C, et al. Colorectal cancer liver metastases-a population-based study on incidence, management and survival. BMC Cancer, 2018, 18(1): 78.
20.	Bulajic P, Bidzic N, Djordjevic V, et al. Impact of genetics on neoadjuvant therapy with complete pathological response in metastatic colorectal cancer: case report and review of the literature. Balkan J Med Genet, 2019, 22(1): 75-80.
21.	Kawaguchi Y, Lillemoe HA, Vauthey JN. Gene mutation and surgical technique: suggestion or more? Surg Oncol, 2019, [Epub ahead of print].
22.	Maeng CH, Ahn HK, Oh SY, et al. Practice patterns of multidisciplinary team meetings in Korean cancer care and patient satisfaction with this approach. Korean J Intern Med, 2019, [Epub ahead of print].
23.	Yu L, Wang L, Tan Y, et al. Accuracy of magnetic resonance imaging in staging rectal cancer with multidisciplinary team: a single-center experience. J Cancer, 2019, 10(26): 6594-6598.
24.	Chen CH, Hsieh MC, Lao WT, et al. Multidisciplinary team intervention associated with improved survival for patients with colorectal adenocarcinoma with liver or lung metastasis. Am J Cancer Res, 2018, 8(9): 1887-1898.
25.	Prades J, Borras JM. Shifting sands: adapting the multidisciplinary team model to technological and organizational innovations in cancer care. Future Oncol, 2014, 10(13): 1995-1998.

1. 张木根, 刘旭超, 连飞, 等. 经导管肝动脉化疗栓塞术联合射频消融在结肠癌肝转移患者中的应用. 华南国防医学杂志, 2019, 33(9): 649-651.
2. 闫晓菲, 李记彬, 李文雅, 等. 结肠癌伴可切除肝肺转移术前新辅助化疗一例. 中华结直肠疾病电子杂志, 2019, 8(1): 91-93.
3. Salah S, Ardissone F, Gonzalez M, et al. Pulmonary metastasectomy in colorectal cancer patients with previously resected liver metastasis: pooled analysis. Ann Surg Oncol, 2015, 22(6): 1844-1850.
4. Hattori N, Kanemitsu Y, Komori K, et al. Outcomes after hepatic and pulmonary metastasectomies compared with pulmonary metastasectomy alone in patients with colorectal cancer metastasis to liver and lungs. World J Surg, 2013, 37(6): 1315-1321.
5. Chow FC, Chok KS. Colorectal liver metastases: an update on multidisciplinary approach. World J Hepatol, 2019, 11(2): 150-172.
6. Pulitanò C, Bodingbauer M, Aldrighetti L, et al. Liver resection for colorectal metastases in presence of extrahepatic disease: results from an international multi-institutional analysis. Ann Surg Oncol, 2011, 18(5): 1380-1388.
7. Akbarzadeh Khiavi M, Safary A, Somi MH. Recent advances in targeted therapy of colorectal cancer: impacts of monoclonal antibodies nanoconjugates. Bioimpacts, 2019, 9(3): 123-127.
8. Tsukamoto S, Kinugasa Y, Yamaguchi T, et al. Survival after resection of liver and lung colorectal metastases in the era of modern multidisciplinary therapy. Int J Colorectal Dis, 2014, 29(1): 81-87.
9. Gonzalez M, Robert JH, Halkic N, et al. Survival after lung metastasectomy in colorectal cancer patients with previously resected liver metastases. World J Surg, 2012, 36(2): 386-391.
10. Wang Z, Wang X, Yuan J, et al. Survival benefit of palliative local treatments and efficacy of different pharmacotherapies in colorectal cancer with lung metastasis: results from a large retrospective study. Clin Colorectal Cancer, 2018, 17(2): e233-e255.
11. Margalit O, Shacham-Shmueli E, Lawrence YR, et al. Lung metastasis predicts better prognosis in metastatic colorectal cancer with mutated KRAS. Clin Colorectal Cancer, 2019, 18(3): e300-e307.
12. Song H, Zhong LP, He J, et al. Application of Newcastle disease virus in the treatment of colorectal cancer. World J Clin Cases, 2019, 7(16): 2143-2154.
13. Reijonen P, Kivelä A, Rantonen J, et al. Long-term outcome after sequential liver and lung metastasectomy is comparable to outcome of isolated liver or lung metastasectomy in colorectal carcinoma. Surg Oncol, 2019, 30: 22-26.
14. Zizzo M, Galeone C, Braglia L, et al. Long-term outcomes after surgical resection for synchronous or metachronous hepatic and pulmonary colorectal cancer metastases. Digestion, 2019, [Epub ahead of print].
15. Sparchez Z, Mocan T, Hajjar NA, et al. Percutaneous ultrasound guided radiofrequency and microwave ablation in the treatment of hepatic metastases. A monocentric initial experience. Med Ultrason, 2019, 21(3): 217-224.
16. Shibutani M, Nagahara H, Fukuoka T, et al. Efficacy of adjuvant chemotherapy according to the classification of recurrence risk based on systemic inflammatory markers in patients with liver metastases of colorectal cancer. Anticancer Res, 2019, 39(9): 5039-5045.
17. Leung U, Gönen M, Allen PJ, et al. Colorectal cancer liver metastases and concurrent extrahepatic disease treated with resection. Ann Surg, 2017, 265(1): 158-165.
18. Li J, Yuan Y, Yang F, et al. Expert consensus on multidisciplinary therapy of colorectal cancer with lung metastases (2019 edition). J Hematol Oncol, 2019, 12(1): 16.
19. Engstrand J, Nilsson H, Strömberg C, et al. Colorectal cancer liver metastases-a population-based study on incidence, management and survival. BMC Cancer, 2018, 18(1): 78.
20. Bulajic P, Bidzic N, Djordjevic V, et al. Impact of genetics on neoadjuvant therapy with complete pathological response in metastatic colorectal cancer: case report and review of the literature. Balkan J Med Genet, 2019, 22(1): 75-80.
21. Kawaguchi Y, Lillemoe HA, Vauthey JN. Gene mutation and surgical technique: suggestion or more? Surg Oncol, 2019, [Epub ahead of print].
22. Maeng CH, Ahn HK, Oh SY, et al. Practice patterns of multidisciplinary team meetings in Korean cancer care and patient satisfaction with this approach. Korean J Intern Med, 2019, [Epub ahead of print].
23. Yu L, Wang L, Tan Y, et al. Accuracy of magnetic resonance imaging in staging rectal cancer with multidisciplinary team: a single-center experience. J Cancer, 2019, 10(26): 6594-6598.
24. Chen CH, Hsieh MC, Lao WT, et al. Multidisciplinary team intervention associated with improved survival for patients with colorectal adenocarcinoma with liver or lung metastasis. Am J Cancer Res, 2018, 8(9): 1887-1898.
25. Prades J, Borras JM. Shifting sands: adapting the multidisciplinary team model to technological and organizational innovations in cancer care. Future Oncol, 2014, 10(13): 1995-1998.

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CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

MDT discussion of a case of recurrent metastatic colon cancer

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