Simultaneous Laparotomy Resection of Recurrent Colorectal Cancer and Liver Metastases Followed by FOLFIRI Adjuvant Chemotherapy: A Case Report

Abstract

Background: Colorectal cancer is one of the most common cancers in the world. Combination of systemic therapies with liver resection in colorectal liver metastasis has been shown to be effective in providing promising survival benefits. Here, we present a case of colorectal liver metastases in which we devised a multidisciplinary treatment plan for a better prognosis Objectives and methods: We report a case of a 68 year old male who developed recurrent colorectal cancer with liver metastases after six cycles of chemotherapy one year previously. Radiological examination before liver resection demonstrated evident tumor from metastatic lesion in segment 4b and segment 8 of the liver (figure 1). Simultaneous laparotomy resection of the colorectal cancer and the liver metastasis was performed. The patient is now undergoing adjuvant combination chemotherapy with folinic acid, fluorouracil, and irinotecan (FOLFIRI) and has no signs of recurrence. Results: Time interval from the initial colorectal surgery to first hepatic surgery has a median 11 months. Tumor recurrence after resection of colorectal metastasis remains a major problem, about 50% to 75% of the patients develop a recurrence of the disease within two years. A multidisciplinary approach including systemic chemotherapy with or without biologic agents in combination with colorectal liver metastases resection are recommended for all patients, unless there are some contraindications Conclusions: The combination of surgery and adjuvant chemotherapy is a possible treatment of choice to cure colorectal liver metastases. Planned surveillance after metastasectomy may be necessary for the early detection of recurrence.