Summary:
The case review describes a case of a patient, hospitalized with T3N0M1 carcinoma of the splenic flexure, with multiple metastases
in the both liver lobes. The patient underwent left- sided hemicolectomy with cholecystectomy. Having considered the inoperable liver
findings, a chemoport was implanted. The patient underwent 10 chemotherapy cycles with no major complications recorded. The chemotherapy
cycle included Campto, Leucovorin, 5FU and, concomittantly, 5FU as a continual 22-hour infusion into the port. After completion
of the Cycle 10, the ultrasound and CT findings showed marked regression of the metastases, by half to two thirds. Following
consultation at the onco-surgical seminar, extended left-sided hemihepatectomy was performed. The procedure lasted 6 hours, the blood
loss was 3.500 ml, the period of warm ischemia was 8 minutes. Based on the oncologists’ recommendation, the chemoport was preserved.
The latest abdominal ultrasound detected no focal liver changes, a hypechogenic to unechogenic septed formation, v.s. a postoperative
hematoma, was detected near the medial liver margin. Based on the conclusion of the oncological assessment, the patient was indicated
for adjuvant chemotherapy, containg the same agents, for a period of 2–3 months. The aim of this report is to present a case of
downstaging of the originally inoperable finding of the liver metastases.
Key words:
liver metastases – chemoport – downstaging – liver resection
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