J Korean Surg Soc.  2005 Feb;68(2):157-162.

The Novel Approach of Multiple Colon Cancer Liver Metastases Treatment

• Chu CW
• Kim HC
• Lim CW
• Shin EJ
• Cho GS
• Yu KW
• Song OP
• Hong DS
• Park SJ
• Cho JH
• Lee HK
• Kim HK
• Kwon KW
• Koh ES

Abstract

Multiple bilobar liver metastases (MBLM) are the main cause of low resectability in the colon cancer liver metastases. The authors experienced one case of initially non-resectable colon cancer liver metastases. He was curatively and safely treated with a two-stage hepatectomy using the new method of future remnant liver volume growing. A 54-year-old man was referred to our department with the sigmoid colon cancer combined with MBLM, which were checked in two small metastatic lesions in the left lobe and five large sized lesions in the right lobe in the computed tomogram (CT). At first, a laparoscopy-assisted anterior resection was performed. We performed the 1st stage hepatectomy 3 weeks after the colon resection. Intra-operative Ultrasonogram (US) found 9 small superficial metastatic lesions in the left lobe. All that lesions were completely removed by non-anatomical wedge resection. An occlusion balloon catheter was placed in the right portal vein through a small branch of the inferior mesenteric vein at that time. The future remnant liver volume was sufficiently increased 3 weeks after the 1st hepatectomy. A right hepatectomy was safely performed 22 days after the 1st hepatectomy. The patient had received a regional chemotherapy (interleukin2 based immuno-chemotherapy through hepatic artery) for 6 months, then has been receiving a systemic chemotherapy (biweekly Oxaliplatin, leucovorin, plus 5-fluorouracil) without any recurrence evidence.

Keyword

Multiple bilobar liver metastases; Colon cancer liver metastases; Two-stage hepatectomy; Occlusion balloon catheter

MeSH Terms

Catheters
Colon*
Colonic Neoplasms*
Drug Therapy
Hepatectomy
Humans
Leucovorin
Liver*
Mesenteric Veins
Middle Aged
Neoplasm Metastasis*
Portal Vein
Recurrence
Sigmoid Neoplasms
Ultrasonography
Leucovorin