Clinical case of multivisceral en bloc resection for locally advanced cancer of the colon hepatic flexure

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Abstract

BACKGROUND: Currently, 15–20% of colorectal cancer cases are diagnosed at the locally advanced T4b stage. Treatment of this category of patients causes significant difficulties due to the degree of prevalence and the presence of a complicated course of the disease itself.

AIM: Demonstration of a clinical case with an operation — multivisceral resection with pancreatoduodenal resection — for locally advanced cancer of the right half of the colon, as well as the oncological rationale for this operation.

MATERIAL AND METHODS: This paper describes a case of treatment of a female patient with locally advanced adenocarcinoma of the colon hepatic angle, complicated by toxic-anemic syndrome and symptoms of partial intestinal obstruction. She underwent en bloc multivisceral resection with pancreatoduodenal resection.

RESULTS: The patient was discharged on the 10th day after surgery in satisfactory condition, no complications were registered. Subsequently, adjuvant treatment was carried out: 5 courses of therapeutic polychemotherapy according to the XELOX regimen (capecitabine was received on an outpatient basis at a dose of 1500 mg 2 times a day, course 2 weeks). 12 months after surgery, progression of the disease in the form of metastases to the lungs was established, and 6 courses of bevacizumab therapy were administered. Currently the process has stabilized.

CONCLUSION: A clinical case demonstrates the possibility of R0 resection for locally advanced cancer of the colon hepatic flexure with ingrowth into the liver, pancreas, duodenum and achieving good long-term results.

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About the authors

Vasiliy I. Egorov

Kazan State Medical University; Republican Clinical Oncology Dispensary

Author for correspondence.
Email: drvasiliy21@gmail.com
ORCID iD: 0000-0002-6603-1390
SPIN-code: 7794-4210

MD, Cand. Csi. (Med.), Assistant, Depart. of Oncology, Radiation Diagnostics and Radiation Therapy; Oncologist, Oncology Depart. No. 11

Russian Federation, Kazan; Kazan

Foat Sh. Akhmetzyanov

Kazan State Medical University; Republican Clinical Oncology Dispensary

Email: akhmetzyanov@mail.ru
ORCID iD: 0000-0002-4516-1997
SPIN-code: 8908-4761

MD, Dr. Sci. (Med.), Prof., Head of Depart., Depart. of Oncology, Radiation Diagnostics and Radiation Therapy; Head, Surgical Clinic LDK2

Russian Federation, Kazan; Kazan

Harshal A. Kaulgud

Republican Clinical Oncology Dispensary

Email: kaulgudh@yahoo.com
ORCID iD: 0000-0002-6395-5088
SPIN-code: 1670-5876

MD, Oncologist

Russian Federation, Kazan

David M. Ruvinskiy

Republican Clinical Oncology Dispensary

Email: ruvindm@mail.ru
ORCID iD: 0000-0002-5217-7276
SPIN-code: 8998-8416

MD, Oncologist, Head of Depart., Depart. No. 11 of Oncology

Russian Federation, Kazan

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Supplementary files

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1. JATS XML
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2. Fig. 1. Computer tomogram of the chest and abdominal organs dated 04/12/2022. Focus on S3 of the right lung with a metastatic focus with a decay cavity

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3. Fig. 2. Computer tomogram of the chest and abdominal organs dated 02/01/2024. Focus on S3 of the right lung; a previously identified metastatic focus with a cavity was not identified

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