[A Case of Successful Multiple Surgeries for Oligometastasis from Rectal Cancer Including Diaphragmatic Metastasis]

The patient was an 81-year-old man. He underwent laparoscopic rectal resection and hepatectomy in 2 stages for Rb rectal cancer and synchronous liver metastasis, followed by adjuvant chemotherapy. One year after the hepatectomy, the cancer metastasized to liver and lung, and a second hepatectomy and right lung partial resection were performed in 2 stages, along with preoperative and postoperative chemotherapy. One year after the lung partial resection, the cancer metastasized to right diaphragm. Since it was isolated, we decided to perform local resection, and performed a J-shaped thoraco-laparotomy. The tumor was located mainly in the diaphragm and was attached to the liver resection surface and the right lung, so we performed local resection by partially resecting the liver and lung. The pathology showed moderately to well-differentiated adenocarcinoma, a finding that was not inconsistent with metastasis of colorectal cancer. The patient has been recurrence-free for 2 years and 6 months since the diaphragmatic resection, and has survived for 5 years and 2 months since the initial surgery. We report a case of long-term survival after four surgeries for oligometastasis of rectal cancer, including diaphragmatic metastasis.