[Curative Resection of Rectal Cancer with Simultaneous Pulmonary and Hepatic Metastasis by Multidisciplinary...

Area of Science:

• Oncology
• Surgical Oncology
• Gastroenterology

Background:

• Stage IV rectal cancer with distant metastases presents complex treatment challenges.
• Concurrent lung and liver metastases significantly complicate management.
• Multidisciplinary approaches are crucial for optimizing outcomes in advanced rectal cancer.

Purpose of the Study:

• To report a successful case of R0 resection in a patient with Stage IV rectal cancer and concurrent lung and liver metastases.
• To illustrate the efficacy of a multidisciplinary treatment strategy combining staged surgery and systemic chemotherapy.
• To highlight the potential for achieving complete response in complex metastatic rectal cancer cases.

Main Methods:

• A 60-year-old female patient diagnosed with Stage IVb rectal cancer with lung and liver metastases underwent laparoscopic low anterior resection.
• Diagnostic subregional resection of lung lesions confirmed metastasis.
• Systemic chemotherapy (FOLFOX plus panitumumab) was administered, followed by partial liver resection for residual/new lesions.
• Pathological examination assessed treatment response and confirmed R0 resection status.

Main Results:

• The multidisciplinary treatment resulted in significant shrinkage of liver tumors after chemotherapy.
• All resected metastatic lesions, including lung and liver, demonstrated pathological findings consistent with complete response (CR).
• The patient achieved R0 resection, indicating complete removal of all tumors.

Conclusions:

• Staged surgical resection combined with systemic chemotherapy can be an effective strategy for managing Stage IV rectal cancer with multiple distant metastases.
• Achieving R0 resection is feasible even in cases with concurrent lung and liver involvement.
• This case underscores the importance of tailored, multidisciplinary treatment plans for advanced rectal cancer.