[Long-Term Recurrence-Free Survival in a Patient Who Received Chemotherapy for Multiple Metastases of Rectal Cancer Including the Lesser-Curvature Lymph Node Metastasis-A Case Report].

A 49-year-old man was preoperatively diagnosed with rectosigmoid carcinoma, c-T4a, N3, M1b, Stage Ⅳb. On CT, lymph node swelling outside that area, including lesser-curvature lymph nodes(LNS), and liver metastases were seen. Laparoscopic high anterior resection was performed with the aim of local control. Additionally, D3 dissection and LNS sampling were performed. The tumor had invaded the bladder wall, and removed LNS were positive for metastasis. The final diagnosis was f-T4b, N3, M1b, Stage Ⅳb. One month after surgery, a CV port was implanted, and chemotherapy was initiated for unresectable cancer. The regimen was capecitabine and oxaliplatin(CAPOX)plus bevacizumab(BEV). After 5 courses, the patient was hospitalized for a CV thrombus that had occurred, and his chemotherapy was withdrawn for approximately 1 month while he was receiving antithrombotic therapy. After discharge, BEV was discontinued, and he received CAPOX alone. Bleeding from a pituitary adenoma was seen after a total of 19 courses. He was hospitalized for 2 months for the treatment, including surgery. A clinical complete response was determined based on CT and PET-CT performed after chemotherapy had been withdrawn for approximately 3 months. For approximately 1 year since the chemotherapy was discontinued, progression-free survival has been maintained.