[A Case of Recurrent Colon Cancer with Long-Term Complete Response Treated with FOLFOX Therapy].

A 69-year-old female was admitted to our hospital due to general malaise and appetite loss. On physical examination, a tumor was palpable in the upper left abdomen. A complete blood count revealed anemia. An abdominal computed tomography suggested ileus secondary to transverse colon cancer. Transverse colectomy with D3 lymph node dissection was performed. The final diagnosis was moderately differentiated tubular adenocarcinoma, StageⅡ, T4aN0M0. The tumor marker level was re-elevated at 9 months after surgery; computed tomography and lower gastrointestinal endoscopy indicated local recurrence. The patient underwent a second laparotomy; however, it became an exploratory surgery due to aggressive local invasion. FOLFOX therapy was initiated from postoperative day 55 for tumor control. Tumor markers decreased markedly after 5 courses of therapy, and a complete response was achieved at 6 months after the second surgery. Subsequently, 29 courses of FOLFOX therapy were administered for 2 years and 1 month. At this time, the patient discontinued chemotherapy at her desire. No signs of recurrence have been observed at 6 years after withdrawal.

[A Case of Gastrointestinal Perforation in a Patient with Colon Cancer and Stent Placement during Bevacizumab Treatment, Alleviated with Conservative Therapy].

The case involved a 52-year-old man. He was diagnosed with sigmoid colon cancer and multiple liver and lung metastases. After placement of a metallic stent for circumferential stricture, 5-fluorouracil/Leucovorin/oxaliplatin (FOLFOX4) plus bevacizumab therapy was introduced. After 17 courses, gastrointestinal perforation was noted at the site of stent placement, but this was alleviated with conservative therapy. Although gastrointestinal perforation is known to be a serious complication that occurs during chemotherapy combined with bevacizumab, further studies are needed to investigate the incidence of gastrointestinal perforation after stent placement more fully.

Comparison between surgical outcomes of colorectal cancer in younger and elderly patients.

AIM: To compare the outcome of surgical treatment of colorectal adenocarcinoma in elderly and younger patients. METHODS: The outcomes of 122 patients with colorectal adenocarcinoma who underwent surgical treatment between January 2004 and June 2009 were analyzed. The clinicopathological and blood biochemistry data of the younger group (< 75 years) and the elderly group (≥ 75 years) were compared. RESULTS: There were no significant differences between the two groups in operation time, intraoperative blood loss, hospital stay, time to resumption of oral intake, or morbidity. The elderly group had a significantly higher rate of hypertension and cardiovascular disease. The perioperative serum total protein and albumin levels were significantly lower in the elderly than in the younger group. The serum carcinoembryonic antigen level was lower in the elderly than in the younger group, and there was a significant decreasing trend after the operation in the elderly group. CONCLUSION: The short-term outcomes of surgical treatment in elderly patients with colorectal adenocarcinoma were acceptable. Surgical treatment in elderly patients was considered a selectively effective approach.