[A long-term disease-free survival case of advanced rectal cancer with massive metastasis to the lateral pelvic and para-aortic lymph nodes]

Abstract

A 42-year-old man with advanced rectal cancer underwent a low anterior resection with TME and pelvic lateral lymph-node and paraaortic lymph-node dissections. Pathological examination revealed as Type 2, 84 × 70 mm, tub 2 > por, A-SE, int, INF b, ly3, v1, pN3 (35/68), M1 (No. 216: 24/37), Stage IV (Cur B) by Japanese Classification of Colorectal Carcinoma. Three kinds of chemotherapy, 3 courses of irinotecan and bolus fluorouracil plus Leucovorin (IFL), 4 courses of irinotecan and S-1 (IRIS), and one-year of S-1 were administered sequentially. After 5 years from the operation, the patient survived and showed no sign of recurrence. Aggressive lymph-node dissection for rectal cancer patients with massive lymph-node metastasis followed by intensive chemotherapy may result in long-term survival.