[Long-Term Suppression with First-Line Chemotherapy(FOLFIRI plus BV)for Peritoneal Metastasis].

Area of Science:

• Oncology
• Surgical Oncology
• Medical Oncology

Background:

• A 72-year-old male diagnosed with Stage IIIB transverse colon cancer (pT4aN1aM0) underwent right hemicolectomy and adjuvant capecitabine plus oxaliplatin (CAPOX) chemotherapy.
• The patient experienced intra-abdominal recurrence 3 years post-surgery, necessitating tumorectomy and subsequent CAPOX with bevacizumab (BV) adjuvant therapy.

Observation:

• Two years after tumorectomy, peritoneal metastasis recurred, leading to the implantation of a central venous port for outpatient chemotherapy.
• The patient received fluorouracil, Leucovorin, and irinotecan (FOLFIRI) plus bevacizumab (BV), but treatment was interrupted due to a central venous port-related infection.
• Following treatment discontinuation, the patient developed spondylodiscitis and, 8 years after the initial surgery, presented with multiple liver metastases.

Findings:

• The case illustrates the challenges of managing recurrent and metastatic colon cancer, including the need for diverse treatment modalities.
• Central venous port-related infections pose a significant complication, potentially hindering the delivery of essential long-term chemotherapy.
• The progression to liver metastasis despite multiple lines of treatment underscores the aggressive nature of the disease in this patient.

Implications:

• Implementing robust infection control protocols is paramount for patients undergoing prolonged chemotherapy for advanced or recurrent colorectal cancer.
• This case emphasizes the importance of multidisciplinary care, integrating surgical, medical, and interventional radiology expertise for optimal patient outcomes.
• Further research into optimizing treatment strategies and managing treatment-related complications in metastatic colon cancer is warranted.