A CASE OF MULTIPLE HEPATIC METASTASES OF RECTAL CANCER IN WHICH COMPLETE NECROSIS WAS CONFIRMED BY HEPATIC RESECTION AFTER INTRAHEPATIC ARTERIAL INFUSION THERAPY

A case of multiple hepatic metastases of rectal cancer in which histologic complete necrosis was confirmed by hepatic resection after intrahepatic arterial infusion therapy is reported. A 62-year-old woman had two metastatic lesios in the right lobe of the liver 3 months after a high anterior resection for rectal cancer. Intrahepatic arterial infusion therapy with 30mg of ADR, 10mg of MMC, and 5ml of lipiodol was performed. Thereafter intermittent intrahepatic arterial infusion therapy was performed through an indwelt reservoir; and the total doses amounted to 21.3g for 5-Fu and 80mg for CDDP, comprising of 4 times of 5Fu 2000mg/m2/48hrs qw, 5 times of 5-Fu 1000mg/m2/5hrs qw, and 4 times of 5-Fu 1000mg/m2/5hrs qw added 20mg CDDP. No shrinkage of hepatic metastatic foci was revealed on CT findings. A hepatectomy was performed. Histopathological exploration revealed that hepatic metastatic foci showed prominent degenerative necrosis and no viable tumor cells were demonstrated. There have been no signs of recurrence, as of 4 years and 10 months after the hepatic resection. In this case, the degree of shrinkage on imaging of the metastatic foci did not compatible with histological effects of the infusion therapy, and hence the difficulty in evaluating the effect of intrahepatic arterial infusion therapy has been suggested.