A Case Report of Successful Conversion Therapy with XELOX + Bevacizumab in a Patient with AFP-producing Colon Cancer and Synchronous Liver Metastases

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  • Sawada Akifumi
    Department of Gastroenterological Surgery I, Hokkaido University Graduate School of Medicine
  • Homma Shigenori
    Department of Gastroenterological Surgery I, Hokkaido University Graduate School of Medicine
  • Yoshida Tadashi
    Department of Gastroenterological Surgery I, Hokkaido University Graduate School of Medicine
  • Shibasaki Susumu
    Department of Gastroenterological Surgery I, Hokkaido University Graduate School of Medicine
  • Kawamura Hideki
    Department of Gastroenterological Surgery I, Hokkaido University Graduate School of Medicine
  • Wakayama Kenji
    Department of Gastroenterological Surgery I, Hokkaido University Graduate School of Medicine
  • Kakisaka Tatsuhiko
    Department of Gastroenterological Surgery I, Hokkaido University Graduate School of Medicine
  • Yokoo Hideki
    Department of Gastroenterological Surgery I, Hokkaido University Graduate School of Medicine
  • Kamiyama Toshiya
    Department of Gastroenterological Surgery I, Hokkaido University Graduate School of Medicine
  • Komatsu Yoshito
    Departments of Cancer Center, Hokkaido University Hospital
  • Yuki Satoshi
    Departments of Gastroenterology and Hepatology, Hokkaido University Hospital
  • Hatanaka Kanako
    Departments of Surgical Pathology, Hokkaido University Hospital
  • Taketomi Akinobu
    Department of Gastroenterological Surgery I, Hokkaido University Graduate School of Medicine

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Other Title
  • XELOX＋bevacizumab療法が奏効しR0切除が得られたAFP産生大腸癌同時性肝転移の１例

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<p>AFP-producing colorectal cancer is a rare condition that carries a poor prognosis due to the high incidence of synchronous liver metastasis. Herein, we present the case of a patient diagnosed as having an AFP-producing colon cancer with synchronous liver metastases, who was successfully treated by conversion therapy using XELOX (capecitabine and oxaliplatin) plus bevacizumab. The 65-year-old male patient was referred to us with multiple liver tumors diagnosed by abdominal ultrasonography at another hospital. The patient’s serum AFP level was elevated to 1,636 ng/mL, and colonoscopy showed a type 2 tumor with circumferential stenosis of the transverse colon. After an abdominal contrast-enhanced CT revealed multiple liver metastases, the patient was diagnosed as having AFP-producing transverse colon cancer with synchronous liver metastases. After resection of the cancer, chemotherapy with XELOX plus bevacizumab was initiated. The liver tumors showed significant reduction in size and were assessed as resectable after eight cycles of treatment. Accordingly, right hepatectomy was performed and the liver metastases were completely resected. Tumor recurrence was detected in the remnant liver of S4 19 months after the lobectomy, and partial hepatectomy was performed. The patient experienced no further recurrence as of 40 months after the first operation.</p>

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