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Related Experiment Video

Updated: Apr 14, 2026

Robot-assisted Total Mesorectal Excision and Lateral Pelvic Lymph Node Dissection for Locally Advanced Middle-low Rectal Cancer
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Aggressive multimodality treatment for advanced rectal cancer.

Ryo Inada1, Takeshi Nagasaka, Toshiaki Toshima

  • 1Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan.

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Summary

This case study highlights successful long-term survival in advanced rectal cancer through aggressive multimodal therapy. Combining local and systemic treatments for recurrence and metastasis is key for extended disease control.

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Area of Science:

  • Oncology
  • Surgical Oncology
  • Medical Oncology

Background:

  • Advanced lower rectal adenocarcinoma presents significant treatment challenges.
  • Initial diagnosis was moderately differentiated adenocarcinoma, pStage IIIB (T3, N2a, M0).

Observation:

  • A 55-year-old woman with advanced rectal cancer underwent low anterior resection with total mesorectal excision.
  • Local pelvic recurrence was detected 26 months post-surgery, leading to total pelvic exenteration with distal sacrectomy (TPES) after chemotherapy.
  • Multiple lung metastases appeared 6 months after TPES, managed with radiofrequency ablation (RFA) and chemotherapy.

Findings:

  • The patient achieved over 7 years of survival from initial recurrence.
  • Disease has been controlled for 38 months following RFA and chemotherapy for lung metastases.
  • Aggressive local and systemic treatments were crucial for managing advanced and recurrent rectal cancer.

Implications:

  • This case underscores the importance of aggressive, multimodal treatment strategies for advanced and recurrent rectal cancer.
  • Combining local therapies (surgery, RFA) with systemic treatments (chemotherapy, targeted drugs) can achieve prolonged disease control.
  • Volume control at metastatic or recurrent sites is critical for improving long-term outcomes in rectal cancer patients.