Successful multidisciplinary therapy for a patient with liver metastasis from ascending colon adenocarcinoma - A case report and review of literature

Sep 24, 2026

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Liver metastasis is a major driver of poor outcomes in colorectal cancer, and hepatectomy remains the only potentially curative option for colorectal liver metastases (CRLM). Yet around one quarter of patients present with disease deemed unresectable. This case describes a 42-year-old man with ascending colon adenocarcinoma and liver metastases initially judged unresectable due to tumor size and right portal vein compression. Multidisciplinary downstaging used preoperative TACE, surgery, neoadjuvant chemotherapy, additional TACE after recurrence, and γ-knife, achieving pathologically complete response and >9-year overall survival.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages9

Reading Time23 min

AccessFree to download

Abstract

Background

Case Summary

Conclusion

Introduction

| W | J | C | C | World Journal of
Clinical Cases | | --- | --- | --- | --- | --- | Submit a Manuscript: [https://www.f6publishing.com](https://www.f6publishing.com) World J Clin Cases 2023 March 6; 11(7): 1498-1505 DOI: 10.12998/wjcc.v11.i7.1498 ISSN 2307-8960 (online) CASE REPORT Successful multidisciplinary therapy for a patient with liver metastasis from ascending colon adenocarcinoma: A case report and review of literature Xiao-Rong Tan, Juan Li, Hua-Wei Chen, Wei Luo, Nan Jiang, Zheng-Bo Wang, Shuai Wang Specialty type: Oncology Provenance and peer review: Unsolicited article; Externally peer reviewed. Peer-review model: Single blind Peer-review report’s scientific quality classification Grade A (Excellent): A Grade B (Very good): 0 Grade C (Good): C Grade D (Fair): 0 Grade E (Poor): E P-Reviewer: Osera S, Japan; Surlin VM, Romania; Teragawa H, Japan Received: September 20, 2022 Peer-review started: September 20, 2022 First decision: December 26, 2022 Revised: January 7, 2023 Accepted: February 10, 2023 Article in press: February 10, 2023 Published online: March 6, 2023 Xiao-Rong Tan, Oncological Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital of Xinjiang Medical University, School/Hospital of Stomatology Xinjiang Medical University, Urumqi 830054, Xinjiang Uygur Autonomous Region, China Juan Li, Hua-Wei Chen, Wei Luo, Nan Jiang, Zheng-Bo Wang, Shuai Wang, Department of Oncology, Daping Hospital, Army Medical University, Chongqing 400042, China Corresponding author: Shuai Wang, MS, Associate Chief Physician, Department of Oncology, Daping Hospital, Army Medical University, No. 10 Changjiang Branch Road, Yuzhong District, Chongqing 400042, [China.](China. sharondenise_mine@163.com)[ sharondenise_mine@163.com](China. sharondenise_mine@163.com) Abstract BACKGROUND Liver metastasis is the most common form of distant metastasis in colorectal cancer, and the only possible curative treatment for patients with colorectal liver metastases (CRLM) is hepatectomy. However, approximately 25% of patients with CRLM have indications for liver resection at the initial diagnosis. Strategies aimed at downstaging large or multifocal tumors to enable curative resection are appealing. CASE SUMMARY A 42-year-old man was diagnosed with ascending colon cancer and liver metastases. Due to the huge lesion size and compression of the right portal vein, the liver metastases were initially diagnosed as unresectable lesions. The patient was treated with preoperative transcatheter arterial chemoembolization (TACE) consisting of 5-fluorouracil/Leucovorin/oxaliplatin/Endostar® . After four courses, radical right-sided colectomy and ileum transverse colon anastomosis were performed. Postoperatively, the pathological analysis revealed moderately differentiated adenocarcinoma with necrosis and negative margins. Thereafter, S7/S8 partial hepatectomy was performed after two courses of neoadjuvant chemotherapy. Pathological examination of the resected specimen revealed a pathologically complete response (pCR) . Intrahepatic recurrence was detected more than two months after the operation, and the patient was then treated with TACE consisting of irinotecan/Leucovorin/fluorouracil therapy plus Endostar® . Subsequently, the patient was treated with a γ-knife to enhance local control. Notably, a pCR was reached, and the patient's overall survival time was > 9 years. WJCC [https://www.wjgnet.com](https://www.wjgnet.com) 1498 March 6, 2023 Volume 11 Issue 7 Tan XR et al. Successful multidisciplinary therapy in colorectal cancer CONCLUSION Multidisciplinary treatment can promote the conversion of initially unresectable colorectal liver metastasis and facilitate complete pathological remission of liver lesions. Key Words: Initially unresectable colorectal liver metastasis; Conversion chemotherapy; Multidisciplinary therapy; Pathological complete response; Transca

FAQs

Why were the liver metastases initially considered unresectable?

They were initially judged unresectable because of the huge lesion size and compression of the right portal vein.

Which multidisciplinary treatments were used in this case?

The patient received preoperative transcatheter arterial chemoembolization (TACE), radical colectomy with anastomosis, neoadjuvant chemotherapy followed by partial hepatectomy, additional TACE after intrahepatic recurrence, and γ-knife for local control.

What outcome did the therapy achieve?

A pathologically complete response (pCR) was reached, and the patient’s overall survival time exceeded 9 years.

Sep 24, 2026

Uploaded by Himbo