[A case of advanced sigmoid colon cancer with metastases in the liver and the paraaortic lymph nodes successfully treated with 5-FU/l-LV and FOLFOX4 followed by S-1 leading to long-term complete response].

Abstract The patient was a 70-year-old woman with sigmoid colon cancer and metastases in the liver and the paraaortic lymph nodes. We performed sigmoidectomy along with lymph node dissection. The solitary hepatic metastasis was 3 cm in diameter; however, hepatectomy was not performed because metastases in the paraaortic lymph nodes persisted. The serum carcino embryonic antigen(CEA)level was above 200 ng/mL, both preoperatively and postoperatively. After surgery, chemo- therapy was initiated. Initially, weekly 5-fluorouracil and l / -Leucovorin(5-FU/l-LV)therapy was administered 4 times. Subsequently, 5-FU/folinic acid plus oxaliplatin(FOLFOX4)therapy was administered 12 times every 2 weeks. Thereafter, S-1 therapy(orally, 40 mg twice a day, 28 days, followed by 14 days of rest)was initiated. After 3 months of chemotherapy, serum CEA levels decreased rapidly to within the normal limit. Paraaortic lymph node metastases and the hepatic metastasis disappeared after 3 months and 11 months, respectively. S-1 therapy was continued for over 7 years. Currently, it has been over 1 year since the discontinuation of S-1 therapy, and complete response has been maintained for over 9 years since the surgery.