摘要
目的总结1例右半结肠癌肝肺转移并腹膜后转移患者的诊治经过及经验。方法回顾性分析昆明医科大学第一附属医院于2016年8月收治的1例行MDT讨论的右半结肠癌肝肺转移并腹膜后转移患者的临床资料,对其诊治经验进行总结分析,以期为国内学者诊治晚期结直肠癌提供参考意见。结果该患者于MDT前接受了数周期化疗和3次手术切除原发灶及转移灶后,再次发现腹膜后占位,经影像科、肿瘤内科、放疗科和胃肠与疝外科多学科MDT讨论后,认为目前患者的治疗方案主要是手术,术后继续口服化疗药物。患者接受了腹膜后肿瘤切除术+腹腔粘连松解术。术后已获访3个月,未发现复发转移灶,继续随访。结论右半结肠癌合并肝肺转移及腹膜后转移的治疗上主要以术前新辅助治疗,手术切除原发病灶、转移灶和复发病灶为基础,术后结合放化疗和分子靶向治疗在内的综合治疗,同时需定期监测CEA值变化。
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.
作者
张小丽
吴志忠
曾靓
施承民
罗华友
曾玉剑
ZHANG Xiaoli;WU Zhizhong;ZENG Liang;SHI Chengmin;LUO Huayou;ZENG Yujian(Department of Gastrointestinal and Hernia Surgery,The First Affiliated Hospital of Kunming Medical University,Kunming 650032,P.R.China;The National Health Council Key Laboratory of Drug Addiction Medicine,The First Affiliated Hospital of Kunming Medical University,Kunming 650032,P.R.China;Yunnan Institute of Digestive Disease,The First Affiliated Hospital of Kunming Medical University,Kunming 650032,P.R.China)
出处
《中国普外基础与临床杂志》
CAS
2020年第4期476-482,共7页
Chinese Journal of Bases and Clinics In General Surgery
基金
中国健康促进基金会黎介寿院士基金项目(项目编号:LJS-201707)
云南省卫生厅内设机构项目(项目编号:2017NS001)
云南省高层次卫生技术人才培养(项目编号:D-201657)。
关键词
结肠癌
肝肺转移
腹膜后转移
MDT
手术
colon cancer
liver and lung metastasis
retroperitoneal metastasis
MDT
surgery
